Understanding Hormone Replacement Therapy

Mar 19, 2015
Express Scripts’ specialist pharmacists help counsel patients on the benefits and risks of hormone replacement therapy.
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  • Female

All women experience menopause. This is the time beyond the final menstrual period and usually occurs around age 51 years. However, different women may experience menopause years earlier or later than that depending on an individual’s internal time clock.

Menopause can be a difficult transition time because of symptoms such as:

  • Hot flashes
  • Mood swings
  • Vaginal dryness
  • Changes in sleep cycle

Understanding Hormone Replacement Therapy

Express Scripts’ specialist pharmacists often get questions about managing the symptoms of hormonal imbalance that occurs with menopause and can help counsel patients on the benefits and risks of hormone replacement therapy.

There are two common types of therapies for menopause:

  • Systemic therapies include medications that provide estrogen to be absorbed into the bloodstream such as oral treatments, patches, gels or injections
  • Localized therapies include medications that provide relief at specific sites such as vaginal tabs, creams or rings

The choice of therapy for individual women depends on the intensity and location of the symptoms. As a rule, the least amount of medication needed to produce the most optimal health outcomes is best. 

The benefit of hormone replacement therapy is that it can help reverse the symptoms caused by sudden lack of estrogen including fewer mood swings and hot flashes. Systemic hormonal therapy can also help reduce the amount of bone loss, although it’s rarely prescribed for that particular purpose.

However, hormone replacement therapy can also increase the risk of heart disease, stroke, blood clots and breast cancer.

To minimize the risks, it is recommended to use the lowest effective dose systemically and transition to localized forms of therapy as soon as possible because those carry lower risks.

Careful consideration of the benefits and risks of the available therapies is imperative in choosing the best treatment for individual women. Specialist pharmacists can play an important role in providing the much needed information to help physicians and patients make the correct choice.

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