All About Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT) is a treatment for relieving the effects of hormone changes during and after menopause. As the female body ages, hormone levels usually undergo a substantial change, around the mid-40s. As a result, some or all of the symptoms begin to show. HRT is not a cure, since this is a natural result of aging, but it is effective in relieving the discomforts coming from the drop in hormone levels.

Hormone Replacement Therapy (HRT) is used to augment the body’s natural hormone levels. Doctors typically recommend HRT for women approaching menopause, which causes estrogen and progesterone levels to decrease significantly. HRT can help return these levels to normal. Treatments have evolved over the years and generally have become more effective.
Estrogen plays a key role in overall health. Aside from menopause, genetic defects or certain diseases can cause estrogen levels to fall.

In HRT, the therapy can be administered through several different methods for supplying the replacement hormones, including injection, oral medication, skin patches, topical creams and gels, and vaginal suppositories. The last three are widely used because they carry the advantage of lower overall dosage due to their local application (where most of the symptoms are felt) and do not result in unnecessarily high blood levels of estrogen.

The most suitable forms of localized estrogen replacement are:

• topical treatment like vaginal cream containing estriol, available as Ovestin®. It is intended to supply basic levels of estrogen, which is one of the naturally occurring forms of the primary female sex hormone that is naturally found in the body
• an alcohol-based gel formulated for topical use like EstroGel®, which contains estradiol, which is the most potent form of estrogen. This is prescribed in instances where the symptoms are more severe, requiring a stronger level of estrogen
• vaginal suppositories in tablet form like Vagifem® (which does not require a prescription in Israel) and is intended for short-term use in cases of milder symptoms. It is generally preferred as a treatment for cases of urinary tract infection and vaginal discomfort.

Why is HRT prescribed?

As a natural process of aging, there are body changes that start to reduce and eventually stop the production of the essential feminizing hormone estrogen. Hormone replacement therapy is intended to boost back to normal the depleted levels of estrogen. The medication is not a treatment for menopause, but is prescribed by doctors to replace the estrogen that the body was producing naturally until menopause. Hormone therapy is most often used to treat common menopausal symptoms. It has also been used as a preventative against bone loss and reduces fractures in postmenopausal women.

Who is HRT prescribed for?

Menopause is a natural condition brought on by aging. Most women experience some degree of change in their body’s hormone levels and feel a degree of discomfort or even pain as a result of a fall-off in estrogen.

Your doctor may prescribe HRT if you:

• Suffer from moderate to severe hot flashes. Estrogen therapy remains an effective treatment for the relief of menopausal night sweats and hot flashes
• Experience other symptoms of menopause. Estrogen can ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse
• Need to prevent osteoporosis leading to bone loss or fractures, but can’t tolerate or aren’t benefiting from other treatment. Normal estrogen levels help protect against bone-thinning
• Experience early menopause, which means stopped having periods before age 45 (premature or early menopause)
• Have estrogen deficiency through primary ovarian insufficiency
• Estrogen therapy can help decrease the risk of some other health conditions, including osteoporosis, heart disease, stroke, dementia and mood changes.

The need for HRT can vary depending on the symptoms’ severity and frequency – talk to your medical practitioner for more guidance.

What is the effect?

HRT is a treatment for the symptoms of hormonal changes due to aging – it is not a cure. Menopausal symptoms include:

• Hot flashes
• Vulvovaginal atrophy, resulting in dryness in the vagina and vulva
• Painful sex due to a lack of vaginal lubrication
• Decreased bone mineral density, which can eventually lead to fractures coming from osteopenia or osteoporosis
• Lower sexual desire
• Accelerated skin aging
• Changes in body-fat distribution showing up as changed shape
• Joint pain
• Increased occurrence of urinary tract infections (UTIs) due to a thinning of the urethra
• Irregular or absent periods
• Breast tenderness
• Headaches or more noticeable migraines
• Depression, sleep disturbances, mood swings, reduction in levels of attention and fatigue
• The most frequent of these are vaginal dryness and loss of sexual drive.

Why is it so important?

With increasing life spans, women today are living one-third or more of their lives in a postmenopausal state. The quality of life can be significantly affected by the problems caused by insufficient hormones, and HRT is an effective and efficient way to treat the symptoms without significant side effects.

IsraelPharm sells Ovestin (estriol), Estrogel (estradiol), and Vagifem (estradiol). Vagifem is available without a prescription in Israel. Unfortunately, we don’t sell patches or vaginal ring versions of these treatments. (Zolpidem) Take a look at these 3 products on IsraelPharm to see if they meet your needs; feel free to email us and we can help you select the right product.