The 4 main types of hormonal replacement therapy (HRT) are:
- Estrogen-only HRT - This replaces estrogen alone, and is mainly used by women who have had a hysterectomy (removal of the uterus). Estrogen is commonly given as a skin patch, vaginal cream or tablet, or gel. Some examples of estrogen-only HRT medications are:
- Estradiol skin patches and gels (brands like Climara, Vivelle-Dot, Elestrin)
- Vaginal estrogen creams (Premarin and Estrace creams)
- Estradiol tablets (brands like Estrace and Gynodiol)
- Progestogen-only HRT - This replaces progesterone or similar synthetic progestins alone. It is sometimes used by women who cannot take estrogen HRT. Progestogen protects the uterus lining from overgrowth that estrogen can cause. Some examples are:
- Progesterone skin creams, suppositories or injections
- Oral progestins like Provera (medroxyprogesterone) or Aygestin (norethindrone)
- Estrogen and progestogen combined HRT - This is the most common HRT for perimenopausal and postmenopausal women who still have a uterus. The combination helps prevent overgrowth of the uterus lining. Brand examples are:
- PremPro (estrogen/progestin tablet)
- Mimvey (estrogen/progestin tablet)
- Femhrt (estrogen/progetin low dose tablet)
- Custom compounded bioidentical hormone therapy - This customizes treatments using hormones that are identical to those naturally found in women's bodies. Treatments can contain estrogen, progesterone and/or testosterone in creams, capsules or troches. Advantages may include improved side effect profiles. Brands like () provide compounded bioidenticals.
The specific type of HRT used depends on the woman's condition and treatment goals. A doctor will help determine if HRT is appropriate, which formulation is optimal, proper dosage/administration and duration of treatment.
Reasons doctors may prescribe HRT include:
- Alleviating uncomfortable perimenopause or menopause symptoms like hot flashes, night sweats, vaginal dryness, sleep problems and mood changes
- Preventing postmenopausal osteoporosis and bone fractures
- Treating hypoestrogenism (estrogen deficiency) conditions
- Vulvar and vaginal atrophy symptoms like dryness, soreness, irritation
- Loss of libido (low sex drive) linked to hormonal causes like menopause
HRT comes with some risks like blood clots, stroke, heart disease and breast cancer. But for many women, the quality of life benefits outweigh potential risks. Doctors can help patients determine if HRT is suitable based on the patient's medical history and risk factors.
In summary, those are the 4 main types of hormonal replacement therapy. Consult your doctor to see if HRT might help relieve troublesome menopause or perimenopause symptoms. Custom compounded bioidentical hormones from specialty pharmacies may provide an effective option with less side effects.
