What is HRT
Updated: Feb 18, 2022
HRT stands for hormone replacement therapy.
It is the most effective way of treating reproductive hormone imbalance or deficiency states.
In the context of early menopause, perimenopause and menopause, HRT involves a combination of oestrogen, progesterone and testosterone.
Oestrogen
We have oestrogen receptors throughout the body which explains the broad range of symptoms that can occur when oestrogen is low.
The safest way to give oestrogen is “transdermally” or via the skin.
It absorbs easily directly into the blood stream without having to pass the liver and as such reduces the risk of blood clots when given this way.
Oestrogen HRT can be prescribed as a patch, gel, spray or tablet. These regulated drugs contain 17-beta-oestradiol which is identical to the oestrogen we produce most of naturally and so is often described as “body identical”.
There are also combination patches and pills that contain both body identical oestrogen PLUS progestin (these mimic the action of natural progesterone). These are available in continuous or sequential forms.
Progesterone
Oestrogen alone causes the lining of the womb (endometrium) to thicken so for women who have their womb, progesterone is required alongside oestrogen to prevent the endometrium from becoming too thick or cancerous.
Women also often find progesterone beneficial in managing some symptoms such as sleep difficulties.
The safest progesterone is thought to be Utrogestan. This is the only form of “body identical” progesterone available.
This can be added to any of the oestrogen HRT preparations in either a continuous or sequential regime.
The Mirena coil (IUS) contains progestin and releases this locally in the womb thus preventing the womb lining from proliferating. This is helpful as it prevents egg implantation to provide contraception and can treat heavy menstrual bleeding (HMB). It is also licensed to provide the progesterone component to combined HRT regime. Thereby it has a helpful “triple-function” when used in perimenopause.
This is a regulated MRHA approved and BMS recommended nexus toon.
Continuous VS Sequential
It is recommended that Women who are still menstruating should start using a “combined sequential” regime. This triggers a monthly withdrawal bleed where the endometrium is shed. Women who are not menstruating can have a regular amount of oestrogen + progesterone in a “continuous combined” regime that should not trigger a bleed.
Testosterone
This is often the missing piece of the puzzle. We produce testosterone from the ovaries in small quantities and when ovary function reduces so does the level of free testosterone available to the cells of the body. Testosterone is important for energy, libido, strength, cognitive function, metabolic function and mood.
It can be given as a cream or gel. We need to check levels prior to prescribing and it is recommended that oestrogen and progesterone levels are optimised first.
If you are on HRT but not sure if your regime if right for you or you think testosterone may be the missing piece then consider speaking to your GP or book in for a private consultation with me via the website.
If you are considering HRT but have questions or concerns, or difficulty accessing NHS services then book in to discuss your options. (Link in bio)
#hormone replacement therapy
HRT stands for hormone replacement therapy.
It is the most effective way of treating reproductive hormone imbalance or deficiency.
Oestrogen
We have oestrogen receptors throughout the body which explains the broad range of symptoms that can occur when oestrogen is low.
The safest way to give oestrogen is “transdermally” or via the skin.
It absorbs easily into the blood stream without passing the liver. This reduces the risk of blood clots.
Oestrogen HRT can be prescribed as a patch, gel, spray or tablet.
There are also combination patches and pills available in continuous or sequential forms.
Progesterone
Oestrogen alone causes the lining of the womb (endometrium) to thicken so for women who have their womb, progesterone is required alongside oestrogen to prevent the endometrium from becoming too thick or cancerous.
The safest progesterone is thought to be Utrogestan. This is the only form of “body identical” progesterone available.
It can be added to oestrogen HRT preparations in either a continuous or sequential regime.
The Mirena coil contains a progestin that is released locally in the womb thus preventing the womb lining from proliferating. It is a useful form of contraception, treats heavy periods AND can be used with oestrogen as #HRT.
Continuous VS Sequential
Women who are still menstruating should start using a “combined sequential” regime which triggers a monthly withdrawal bleed where the endometrium is shed.
Women who are not menstruating can have a regular amount of oestrogen + progesterone in a “continuous combined” regime that should not trigger a bleed.
Testosterone
We produce testosterone from the ovaries. When ovarian function reduces so does the level of free testosterone. It is important for energy, libido, strength, cognitive function &mood.
It can be given as a cream or gel. We need to check levels prior to prescribing & during treatment.
If you are considering HRT but need more detailed information; if you are on HRT but not sure if your regime is right for you or you think testosterone may be the missing piece of the puzzle then consider booking in for a private consultation via the website👆🏻