What you need to know about:

Hormone Replacement Therapy

Fast Fact

97%

Worth It Rating

Average Cost:

$11,050

Recovery Period:

6 to 12 weeks

Permanence:

1 to 2 years

177

Doctors

Time it takes:

15-30 minutes

Hospitals & Clinics

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Anesthetize:

None

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Overview of

Hormone Replacement Therapy

in Thailand

Menopause is a natural biological process brought about by a decrease in a woman’s estrogen levels. It typically occurs anywhere between the ages of 41 to 55 years old or when a woman’s menstrual cycle has not occurred for more than 12 months.

The decrease in estrogen levels causes a myriad of symptoms such as hot flashes, mood changes, weight gain, and vaginal dryness. For some, these symptoms can negatively affect their everyday lives and routines.

Hormone Replacement Therapy (HRT) is a way to relieve these symptoms by replacing the hormones lost during menopause.

Also called Hormone Therapy, Menopausal Hormone Therapy, and Estrogen Replacement Therapy, HRT has long been recognized as the most effective way to ease the negative effects of menopause.

Goals of

Hormone Replacement Therapy

By bringing balance back into the game, Hormone Replacement Therapy significantly improves the overall menopausal experience. It provides relief from common menopausal symptoms such as hot flashes, fatigue, insomnia, and mood changes.

Aside from these, HRT has been proven to enhance skin moisturization, and reduce skin inflammation and acne. When combined with the right diet and exercise, HRT helps prevent bone loss associated with aging.

Women who experienced “brain fog” – a common term used to describe forgetfulness and difficulty in concentrating - also report an improvement in their focus and concentration while undergoing HRT.

Price of

Hormone Replacement Therapy

Average Cost

$11,050

Price Range

$8,400 to $13,700

Pros and cons of

Hormone Replacement Therapy

Pros

Estrogen only treatment

Women undergoing Estrogen-Only Treatment experience an 85% reduction in the severity and frequency of hot flashes. This, coupled with a few other notable benefits, makes estrogen the most popular type of hormone replacement therapy.

Studies have shown that oral estrogen therapy alleviates symptoms such as mood changes, vaginal dryness and decreased libido. Unlike other HRT options, Estrogen Therapy is not associated with weight gain. In addition, it can also reduce the risk of fractures by preventing bone loss in older women.

By diminishing the effects of menopause, estrogen improves the quality of life for millions of menopausal women worldwide.

Cons

Just like any other drug, there are some side effects to taking oral estrogen. Some women experience headache, nausea and breast tenderness during the course of treatment.

Estrogen Therapy increases the risk for stroke, blood clots, and heart disease. Several studies also noted that women taking estrogen combined with progestin also have an increased chance of developing breast cancer.

However, it is important to note that these risk factors are also affected by a woman’s age, the presence of other diseases, a history of smoking and obesity.

Healthcare providers work closely with women to discover the best course of hormone treatment relative to their current health status.

How it works:

Hormone Replacement Therapy

Women who have had their uterus removed (also called a hysterectomy) are given estrogen-only therapy. A hysterectomy is done for a number of reasons including endometriosis and severe bleeding. Estrogen can be delivered orally, via skin patch or creams, or through the vagina.

On the other end of the spectrum are women on HRT with intact uteruses. Unlike the first group, these women are given both estrogen and progesterone to reduce their risk of developing endometrial cancer – a type of cancer that begins in the uterus. Also called Combination Therapy, this can be given orally or through IUDs.

The Cyclic Regimen is recommended for women in the early stages of menopause. Estrogen is given for 21 straight days, supplemented by progesterone from Day 9 to Day 21. No hormones are given for next 7 days when the woman is expected to have her period.

As the name implies, the Continuous Combined Regimen (CCR) administers both estrogen and progesterone in the same amount continuously throughout the month. This regimen is given to women who have been in menopause for more than a year. Unlike the cyclic regimen, women in CCR do not expect their periods.

Preparation before

Hormone Replacement Therapy

Pre - treatment

The key to successful HRT Therapy is finding a good support team. Healthcare practitioners with expertise and experience in the field is key in ensuring that you are guided throughout the course of treatment. HRT is a highly individualized process and women are encouraged to explore all options available to them.

HRT can be initiated as soon as a woman starts to experience menopausal symptoms. Depending on your current health status, the doctor may order additional tests or start treatment right away. A low dose of hormones is usually given at the beginning of HRT to assess the patient’s response and gradually increased over time.

As the body slowly adjusts to the hormones, some patients may experience side effects during the initial stage. Symptom relief may not be apparent until the patient has been on HRT for at least a few weeks. If a patient does not experience relief, the doctor may opt to change her dose or offer other options.

Recovery after

Hormone Replacement Therapy

Post - treatment

Patients respond differently to Hormone Replacement Therapy. Some women experience immediate symptom relief while others have to wait a few weeks to feel any difference. In any case, you should work closely with your healthcare provider to ensure that you are receiving proper support during the adjustment period.

Some common side effects to the treatment include bloating, cramps, acne, and breast tenderness. These are reflective of your body’s attempt to balance itself out with the addition of the new hormones.

Risks & side effects

The decision to undergo HRT is affected by factors such as age, weight, current health condition and family medical history. Your healthcare provider will take these into consideration when choosing the right type of HRT for you. Also in consideration is how your body responds to the treatment.

Some women may experience vaginal bleeding in the first 3-4 months of treatment. This, along with breast tenderness and migraines usually resolve within 6 months of consistent HRT use. For some, 6 months may seem like a long time to adjust to a treatment, but keep in mind that this timeline is different for everyone.

Minimizing the side effects of HRT can be done by seeking regular follow ups with your healthcare provider. They can adjust the dose and method of delivery to make sure you get all the benefits of HRT with minimal side effects.

Healthy lifestyle choices – regular exercise, stress management and eating healthy – can also help you manage your symptoms better.

FAQs:

Hormone Replacement Therapy

What are the common hormones for used for hormone replacement therapy?

Hormone Replacement Therapy involves the use of two female sex hormones: estrogen and progesterone. Both are produced by the ovaries and are responsible for the development of distinct female characteristics and fertility. Progesterone and estrogen are necessary for the menstrual cycle, and their release is triggered by the hypothalamus.

Estrogen. Once a girl reaches puberty, her ovaries start to produce estrogen. There are actually different types of estrogen – estrone, estradiol, and estriol – excreted during different stages of a woman’s life. Most estrogens are produced by the ovaries but some are excreted by the adrenal glands and fat cells.

Estrogen’s main function is to regulate a woman’s menstrual cycle. However, it can also affect the urinary tract, the cardiovascular system and the brain. The emergence of secondary sexual characteristics – breast tissue growth, pubic hair, etc. – are also brought about by estrogen.

The quantity of estrogen in the body gradually decreases as the woman ages thereby giving rise to menopause.

Progesterone. Progesterone is a female sex hormone produced in the ovaries. Also called the “pregnancy hormone”, progesterone’s main role is to prepare the body for pregnancy. During the menstrual cycle, progesterone thickens the walls of the uterus in case of a fertilized egg. Progesterone regulates the womb’s internal environment to support the early stages of pregnancy.

Both estrogen and progesterone can be given through HRT.

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At what age do women normally reach menopause?

The onset of menopause depends on a number of factors. Typically, it can occur between the ages of 41 to 55 years old. However, menopause can also be brought about by the early removal of both ovaries (called an oophorectomy). This phenomenon is called surgical menopause. In both cases, the woman can opt for Hormone Replacement Therapy.

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How long can side effects last?

The HRT regimen administers the least number of hormones required to achieve therapeutic effect. The dose is similar to what the body is used to which lowers the risk for long lasting and severe side effects.

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What kinds of patients should NOT be on HRT?

Contraindications to Hormone Replacement Therapy includes a history of breast, ovarian or uterine cancer. If you are at high risk for developing blood clots, liver disease or suffer from uncontrolled blood pressure, your physician may do additional preparations to make sure you’re ready for HRT.

It is possible to get pregnant while you’re on HRT. It is advisable to continue using contraception for 24 months after your last period to be safe.

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When should I stop HRT?

Discontinuing HRT is a personal decision made by the woman with the help of her medical team. Typically, a woman needs to be on HRT for 2-3 years to control the symptoms of menopause. It is discontinued by tapering the dose rather than abruptly ending the treatment in order to ease the body into balance. In some cases, HRT can be used for more than 3 years to prevent osteoporosis.

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