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Hormone Replacement Therapy: Up-to-Date Treatments for Age-Old Symptoms


Hot flashes. Night sweats. Mood swings. Sexual issues.

Many women experience a variety of unpleasant symptoms during perimenopause and menopause, which may include those mentioned above, as well as:

  • urinary urgency
  • dryness of the skin, eyes, mouth, or vagina
  • decreased libido
  • breast tenderness
  • headaches
  • muscle or joint pain
  • weight gain
  • elevated heartbeat
  • cognitive difficulties (memory, concentration)
  • hair loss or thinning

What Is Happening and Why

As a woman ages, her body prepares for the end of her reproductive cycle by making less estrogen. Menopausal symptoms are caused by the body trying to adjust to these hormonal changes.

While some women experience relatively mild changes, others have severe symptoms that interfere with their quality of life. Just a generation or two ago, there was little women could do except suffer through the symptoms, often for years.

Fortunately, today there are numerous treatments that can help.

Hormone replacement therapy (HRT) replaces the estrogen and progesterone that a woman’s body stops making.  This can happen gradually during natural menopause, or abruptly in the case of a hysterectomy. In addition to helping ease symptoms, hormone replacement therapy has been proven to have benefits for postmenopausal women such as protection against heart disease, osteoporosis, type 2 diabetes, cataracts, and recurrent urinary tract infections.

Which Hormones Are Replaced

For women who have not had a hysterectomy, progesterone or progestin is usually prescribed along with estrogen when receiving HRT.   Taken alone, estrogen can increase the risk of endometrial cancer by stimulating growth of the uterus lining. Women who have had a hysterectomy typically do not need to take progesterone.

A significant advancement in HRT in recent decades is the development of bio-identical hormones. These manmade hormones have the exact same chemical structure as those your body naturally produces.

Methods of Delivery

Systemic hormone therapy is absorbed and distributed throughout your body, and is usually delivered through a pill (traditional oral therapy), transdermal skin patch, or cream. Your doctor may prescribe it to help mitigate any of the symptoms of menopause.

Sub-dermal therapy, also called pellet therapy, is a relatively new systemic treatment. A pellet, approximately the size of a grain of rice, is implanted under the skin and hormones are gradually and continually released throughout your body. Research shows approximately 98% of women using pellet therapy for menopausal symptoms are pleased with their results. In addition to relief from common unpleasant symptoms, patients may discover health benefits such as bone density and cardiac protection, higher energy levels and sex drive, and relief from joint pain.

The other primary type of hormone therapy is low-dose vaginal estrogen preparations that are available in ring, tablet or cream form. Because these are localized treatments for vaginal and urinary symptoms exclusively, only a small amount of estrogen is absorbed by the body.

Consult with an Expert in HRT

Before you begin hormone replacement therapy, your gynecologist should thoroughly evaluate your symptoms and general health, as well as your lifestyle and other personal considerations.

G. Daniel Robison, IV, MD, FACOG, FPMRS, is a double board-certified specialist in two areas of women’s health. His experience and expertise cover a wide range of gynecological conditions, including helping women through menopause. He can assess which HRT is best for you, and follow you through treatment, making adjustments if necessary to get you maximal results.

To consult with Dr. Robison about your symptoms and possible treatments, please call Advanced GYN Solutions at 910.509.0103 for an appointment.