Hormone replacement therapy: How best to use, when to avoid

While the treatment is primarily used for symptoms associated with menopause in women, it has also had its fair share of naysayers citing cancer risks. Here's some clarity

- SREYA DEB

HORMONE REPLACEMENT THERAPY (HRT) is emerging as a double-edged sword. While it is meant to provide relief for the hundreds of women undergoing painful menopausal symptoms, research has also found pertinent risks associated with the treatment. It is therefore important to know how best to use it to manage symptoms - and when to steer clear.

A study published by the National Center for Biotechnology Information states that the natural decline in estradiol (a key female sex hormone) during menopause leads to several adverse metabolic and health effects. "Approximately 40% to 60% of women seek treatment, while 20% may delay treatment for over a year," the study adds.

Dr David Chandy, director of endocrinology and diabetology at Sir HN Reliance Foundation Hospital, Mumbai, explains, "HRT is prescribed selectively rather than routinely. Doctors recommend it only when symptoms are significant or when hormone deficiency affects long-term health." While, initially, information and research into HRT were limited and unclear, deeper research, improved safety guidelines, and a more personalised approach to medicine have made the treatment more accessible and "helped rebuild confidence among both doctors and patients".

Who needs it

HRT is most commonly used for women suffering from severe menopausal symptoms. Due to a drastic imbalance in hormonal levels during menopause, HRT serves to replace the hormones that are lacking.

"HRT may be considered when symptoms significantly affect daily life. These include hot flashes, night sweats, sleep disturbances, mood changes, vaginal dryness, and reduced quality of life. Other valid reasons include early or surgical menopause," explains Dr Chandy.