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Hormone Replacement Therapy (HRT)

During menopause, a woman’s body slowly makes less of the hormones estrogen and progesterone. Menopause is a normally occurring event in a woman’s life and, in most cases, happens between the ages of 45 and 55. However, in some women, menopause starts at a younger age. The reasons for this early onset are associated with medical treatments such as surgery to remove the ovaries, family history (genes), or cancer treatments such as chemotherapy or radiation to the pelvic area.

Some women may not have any of the usual symptoms at all. Other women may suffer significantly from symptoms like hot flashes (waves of warm spells in the face, neck, or chest), night sweats or difficulty sleeping, vaginal dryness and thinning of bones, which may lead to loss of height and increased susceptibility to bone fractures.

Common Menopausal Symptoms

The Total HRT market was valued in 2014 at $15 billion and is expected to grow 8.2% per year over the next seven years, regarding a HRT market size report from Grand View Research from March 2016. Thereof approximately 50% belong to estrogen replacement therapy, with a value of $7.5billion. North American dominates the global market with 35% share, though sales of HRT products have decreased significantly in the US since 2002 due to the NIH study regarding serious side effects, though they are expected to grow due to improved safety profile of current treatments.  Menopausal women form the largest section of the market, and the female population between the age of 45 and 59 worldwide is increasing. 

Recent studies have demonstrated that use of bio-identical hormones results a lower risk of cardiovascular events compared to older treatments. The use of bio-identical hormones increased women’s awareness to menopause-based hormone replacement which is expected to be the fastest growing segment in HRT over the next few years.

Like all medicines, hormone replacement therapy has both benefits and risks. If a woman decides to engage in HRT, the lowest effective dose is preferable and a healthcare provider should be consulted to discuss treatment options.

HRT is a system of medical treatments for menopausal (both peri- and post-menopausal) women. It is a treatment regimen that may prevent discomfort caused by diminished circulating estrogen and progesterone hormones. In case of surgically or prematurely menopausal indications, the use of HRT may prolong life and reduce incidence of dementia. The main types of hormones involved are estrogens, progesterone or progestins and, less commonly, testosterone.

Benefits of the use of HRT to treat menopause

HRT is the most effective approach and the FDA has approved medications for relief of menopausal symptoms such as hot flashes, night sweats and vaginal dryness.

Recent studies have again demonstrated that hormones may reduce the likelihood of developing osteoporosis.

What are the risks of using hormones?

For some women, hormone therapy may increase the risk of blood clots, heart attacks, strokes, breast cancer, and gall bladder disease. 

For a woman who has not undergone surgery to remove the uterus, estrogen may increase the risk for developing endometrial cancer (cancer of the uterine lining). Adding progestin to the estrogen regiment lowers this risk.