Debunking Myths About Hormone Replacement Therapy: What You Need to Know
Hormone replacement therapy (HRT) has been used since the 1940s when the FDA approved the marketing of estrogen to treat postmenopausal symptoms. The HRT market has fluctuated over time and has recently experienced a resurgence. The global HRT market is expected to see substantial growth by 2030, driven by an increased occurrence of menopause, a greater awareness of menopause management and greater interest in proactive, personalized health care.
Currently, HRT is the most effective treatment for perimenopausal and postmenopausal symptoms. Nevertheless, there are numerous misconceptions surrounding HRT preventing women and men from seeking treatment.
What Is Hormone Replacement Therapy?
HRT is a medical treatment that involves replacing or replenishing hormones to alleviate symptoms related to declining or deficient hormone levels. In women, HRT is most commonly used to treat menopausal symptoms, such as hot flashes and night sweats, which are caused by a decline in estrogen. HRT typically involves replicating ovarian hormones and administering them orally, transdermally or vaginally depending on the individual patient.
Types of Hormones Often Used in HRT
The three most common types of hormones used in HRT are estrogen, progesterone or progestin and testosterone.
Estrogen
The natural declines of estrogen in a woman’s body due to age can lead to uncomfortable symptoms associated with menopause. Declines in estrogen levels can also contribute to weaker bones. HRT is often used to restore levels of estrogen to address these symptoms and prevent osteoporosis.
Progesterone or Progestin
Women who still have their uterus may be administered progesterone in combination with estrogen during HRT. Estrogen can thicken the lining of the uterus, and progesterone is used to counter this effect, thereby reducing the risk of endometrial cancer.
Testosterone
In both men and women, testosterone levels gradually decline with age. Low testosterone in men can lead to various symptoms, including low sex drive and depressed mood. HRT is sometimes supplemented with testosterone for postmenopausal women to address hypoactive sexual desire disorder. While testosterone therapy is not yet FDA-approved for women, there is FDA-approved testosterone replacement therapy (TRT) for men.
5 Common Myths About Hormone Replacement Therapy
A thorough understanding of HRT is essential for making well-informed healthcare decisions, whether for oneself, a family member or patients. This requires a clear distinction between established facts and prevalent myths. A critical examination of common misconceptions surrounding HRT is the first step.
Myth 1: HRT Is Only for Women Experiencing Menopause
One of the most widespread misconceptions is that HRT is exclusively for women experiencing menopause. While HRT is a frequently prescribed and effective treatment for the symptoms of menopause and perimenopause, its clinical applications are significantly broader. The therapy also addresses various other conditions that stem from hormone deficiencies or imbalances.
For example, HRT is used in the treatment of hypogonadism and andropause in men. Male hypogonadism is characterized by low testosterone production resulting from issues with the gonads, hypothalamus or pituitary gland. Andropause is the term for late-onset hypogonadism.
With TRT, a testosterone preparation is commonly administered through intramuscular or subcutaneous injection, topical gels or transdermal patches. According to recent data, nearly 14% of American men under 40 use or have previously used TRT.
Myth 2: HRT Causes Weight Gain
Currently, no scientific evidence demonstrates that HRT causes significant weight gain. Menopause itself may be the cause of weight gain for some women while undergoing HRT. During menopause, many factors can contribute to weight gain, including a decrease in muscle mass and slower metabolism rate.
Since HRT can relieve menopausal symptoms such as sleep disturbances, it can potentially help some women manage their weight. There is a correlation between improved sleep quality and reduced daily caloric intake as well as an increased likelihood of engaging in physical activity, which are primary factors in facilitating weight loss.
Myth 3: HRT Increases the Risk of Cancer
In 2002, the Women’s Health Initiative (WHI) study caused widespread panic by suggesting that HRT increases breast cancer risk. However, the average age of the women in the study was 63.2 years old — not the typical age of patients seeking HRT.
Since the study’s initial release, the original WHI investigators and scientific community at large have revised and clarified their early conclusions. Further analysis showed that healthy women under 60 or within 10 years of menopause actually experienced minimal risks and many health benefits from HRT.
In fact, in a 2017 paper published in the Journal of the American Medical Association, WHI researchers clarified that taking estrogen and progestin or estrogen alone was not associated with a risk of cancer mortality during a follow-up of 18 years.
Regarding TRT, 2023 research shows that it does not increase the risk of prostate cancer in men with hypogonadism.
Myth 4: Hormone Replacement Therapy Is Not Safe
The reality is that HRT is safe for most women — in particular, those under age 60.
A study published in the Canadian Medical Association Journal concludes that menopausal hormone therapy is a “safe treatment option for patients with no contraindications.” Some evidence has even shown a reduction in mortality in patients who begin menopausal hormone therapy before 60.
Additionally, four medical societies, including the American College of Obstetricians and Gynecologists, recommend HRT for menopause symptoms.
Providers must consider the patient’s overall health, age, symptoms and family history when determining whether the benefits of HRT outweigh any risks that may be present.
Myth 5: All HRT Is the Same
HRT does not look identical for each patient; different types of hormones, administration methods and doses are available, and they are carefully selected for a person’s specific health needs.
Hormones come in synthetic or bioidentical formulations. Synthetic hormones mimic the effects of natural hormones, while bioidentical hormones are chemically identical to the body’s hormones. Both types can be used effectively in HRT, but some providers and patients may prefer bioidentical hormones for highly tailored HRT.
In addition, the delivery of HRT varies. Estrogen, for example, can be administered topically, vaginally or via a patch, pill, injectable or pellets.
In summary, HRT is not one-size-fits-all, and individualized treatment plans are essential for HRT safety and efficacy.
Benefits of Hormone Replacement Therapy
HRT has numerous benefits, ranging from reducing menopausal symptoms to helping prevent certain diseases to simply improving overall quality of life. HRT improves vasomotor symptoms by up to 90% in patients with moderate or severe hot flashes. Vasomotor symptoms improved by HRT include both hot flashes and night sweats. HRT may also reduce the following symptoms: mood swings, vaginal dryness, fatigue and sleep disturbances.
HRT — particularly oral estrogen therapy — can improve insulin sensitivity and potentially reduce the risk of diabetes as a result. HRT also reduces the risk of fractures related to osteoporosis. Lastly, HRT may help keep blood vessels healthy in women experiencing premature or early menopause.
Men can also experience various health benefits through TRT, such as improved mood, greater muscle mass and enhanced libido.
Who Should Consider Hormone Replacement Therapy?
HRT is generally recommended for women experiencing bothersome menopausal symptoms under age 60. Men experiencing symptoms of hypogonadism or andropause, like decreased sex drive, fatigue and trouble losing weight, may consider TRT.
Providers consider a patient’s health, symptoms and goals before initiating HRT regardless of age.
Why Trust Us?
At Spartan Medical Associates, our HRT programs are managed by providers with specialized training and certification in Advanced Bioidentical Hormone Replacement (ABHRT). Our providers not only offer expertise in Advanced BHRT, but they also understand the importance of proactive and personalized care, addressing other factors that impact quality of life and health, like exercise and nutrition.
We take time to provide patient education on HRT, build strong relationships and understand individual needs so we can empower them to maximize their health, feel younger and embrace lasting vitality.
Rejuvenate Your Health With Spartan Medical Associates
Hormonal imbalances or deficiencies can cause a wide range of issues that diminish your quality of life and prevent you from thriving. Through HRT, you can address the root cause of uncomfortable symptoms and regain the energy to live your healthiest life.
As a first step, your provider will take the time to understand your health needs and goals. At Spartan Medical Associates, we tailor all of our HRT programs to each patient’s needs and deliver them with compassion and evidence-based protocols.
Contact our team today to learn more about our individualized treatment plans or schedule a consultation.
