Considering Hormone Replacement Therapy for Menopause? What to Know Before Your Appointment
Menopause comes with a host of uncomfortable symptoms, not all of which lifestyle changes can help effectively.
When we talk to our healthcare providers about how to navigate these new symptoms, we’re often told about hormone therapy or hormone replacement therapy. But what is it, and what does it mean for you?
What is hormone replacement therapy?
Hormone replacement therapy (HRT) helps to stabilize the estrogen and progesterone levels in your body, and is considered one of the most effective treatments available to help alleviate a variety of menopause symptoms, including:
Hot flashes and night sweats
Genitourinary symptoms of menopause, including vaginal dryness, irritation and burning
Mood changes (for some people)
Insomnia (for some people)
Prevention of bone loss and fractures
There are two types of hormone replacement therapies used to treat menopause symptoms – estrogen only, and a combination of estrogen and progesterone (also called combination therapy or EPT).
You may be recommended estrogen-only therapy if you have had a hysterectomy, whereas combination therapy is recommended for those who still have a uterus.
Depending on the type and combination of hormone therapy you’re taking, your doctor can prescribe different ways of taking it.
Local hormone replacement therapy is designed to only treat a specific area of the body, and is often prescribed as a cream, gel or suppository. For example, low dose vaginal estrogen is often prescribed as a cream, tablet or ring, and is used to treat the genitourinary symptoms of menopause, including vaginal dryness, irritation and burning; pain during intercourse or sitting; and frequent urination.
Systematic therapy, whether it’s estrogen-only or a combination of estrogen and progesterone, can be prescribed as a pill, skin patch, ring, gel, cream or spray. Systemic therapy is absorbed by the whole body and can be used to treat many common symptoms of menopause such as hot flashes and night sweats.
Like any medication, hormone replacement therapy doesn’t come without its risks, and should be tailored to each person and their symptoms. The risks will depend on the type of hormone therapy and dose, age, length of time you’re taking it, as well as your own personal health history. Always talk to your healthcare provider to determine the best course of treatment for you.
Common Questions Around Menopause and HRT to Ask Your Doctor
When and why should I start HRT?
What are the risks of HRT?
Should I take natural supplements to treat my symptoms?
How long should I take HRT?
Will hot flashes and other menopausal symptoms return when I quit hormone therapy?
What else beside HRT can I do to ease my symptoms?
Will menopause and HRT affect my libido?
Preparing to have a conversation around menopause with your healthcare provider
A doctor’s appointment can feel like a whirlwind, especially if you’re going in for an annual checkup and wanting to discuss your menopause symptoms at the same time. Determining how you’re going to describe your symptoms and their impact beforehand can help ensure a productive appointment where you leave feeling confident with the outcome.
Here are some tips to help you feel ready and confident when talking to your provider about the menopause transition.
Before Your Appointment
Track Your Symptoms
It's helpful to track your symptoms so that you’re aware of any patterns that you want to bring up to your provider.
Do your research
The Menopause Foundation of Canada has compiled the latest evidence-based research for you to familiarize yourself about various treatment and care options. These are great resources to print and give to your provider if they aren’t experienced in the treatment of menopause symptoms.
During the Appointment
Use “I statements”
Let your provider know the symptoms you’re experiencing and how they’re impacting your life. For example, “I’m having hot flashes and night sweats every couple of hours, and I find I can’t sleep more than a few hours a night because of this.”
Don’t be afraid to share your own research
After hearing your provider’s recommendations, you may feel confident in their advice, or you may feel that their recommendations don’t align with your needs. Now is the time to offer them any information and resources you brought with you. You can use bridging statements such as “I was looking into my symptoms and found.....” or “I came across this information and wanted to share.....”
Ask for a referral
Don’t be afraid to ask for a referral if you feel that you need one. Specialists in Canada can be found at: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx