HRT: What’s a Woman to Do?

When it comes to hormone replacement therapy (HRT), there’s a lot of confusing and controversial information floating around. Some women won’t live without it, while others won’t touch it with a ten-foot pole. And then there’s the medical community. Some say yes, others say no. When and what each will prescribe can be as different as night and day.

So what’s a woman to do? Do you need it or not? And how do you know how much to take?

Start with a symptom diary.

First, keep a symptom diary. It can help you and your doctor see what menopause symptoms you might be having. That can help you both decide if steps need to be taken to address them.

Get a physical.

Before assuming your symptoms are all because of menopause, it’s a good idea to get an overall physical to be sure there are no other issues going on. Some health conditions, like thyroid or pituitary disorders, can cause some of the same symptoms. Treating those underlying health concerns could eliminate many of your symptoms.

Assess your risks.

It’s also important to have your doctor help you assess your risks for some of the more serious health concerns that can go along with menopause. Your doctor may ask if you or your family have a history of cancer, heart disease, osteoporosis, bleeding disorders, or dementia. Your answers could dictate whether or not HRT is right for you.

Now what?

Once you’ve decided HRT is right for you, how to choose the correct delivery system and dose can be the next challenge. Should you be treated according to your numbers or your symptoms? It may depend on your doctor.

There are mixed theories about which may be best for both testing and dosing. Doctors will have varying preferences based on their experience and training, so it’s important to find a doctor you trust who has ideologies similar to your own.

Some medical professionals believe levels should be kept within a certain range to allow for benefits while minimizing risks. Others believe that doses can vary from person to person, so how a woman feels should be the yard stick for choosing amounts.

Choosing testing.

If you and your medical provider believe that it’s all in the numbers, you may then wonder when and what type of testing is best. In theory, hormone testing before a hysterectomy or menopause sounds reasonable. Unfortunately, that may not give you the best information. Hormone levels in women can vary hour by hour, day by day, so no one test prior to menopause is going to give a solid answer. If you needed a hysterectomy, the underlying cause may have been hormonal, so your hormone levels may have already been out of whack.

Then there’s which type of testing is best. Once again, it may depend on your doctor and even your insurance company. There are pros and cons for both blood and saliva testing, so which is right for you may depend on your situation and the specific goal of the testing.

Which HRT?

Deciding to use HRT is only part of the challenge. Then comes the hard part – which one and how much of it. Often, you’ll be started on the lowest dose, adjusting only after you’ve given your body time to try to adapt. What type of HRT you try first may depend on personal preference or insurance coverage. Then, it’s all trial and error to see what delivery system and dose works best for you.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.  Reprinted with permission: HRT: What’s a Woman to Do?