“The type of HRT most suited to a woman will depend on a variety of factors, including her stage in the menopausal process, and whether or not she has had a…”.1

Umbrella
What may the Hormone Therapy Types Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Combined/Combination HT/HRT
  • Continuous HT
  • Continuous Oestrogen and Progestogen Combinations
  • Cyclical/Sequential HT/HRT
  • Estrogen Therapy (ET)
  • Estrogen-Progestogen Therapy (EPT)
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Therapy (MHT)
  • Oestrogen Only HT/HRT/Therapy
  • Oestrogen and Progestogen Combination HRT
  • Progestin/Progestogen

Different Differences

Is hormone therapy (HT) one-size-fits all?

No. In HRT: Which HRT? the (British) Women’s Health Concern explain:

“The type of HRT most suited to a woman will depend on a variety of factors, including her stage in the menopausal process, and whether or not she has had a hysterectomy. Most forms of HRT combine different amounts of the hormones oestrogen and progesterone (manufactured progesterone is called progestogen in the UK and progestin in the US). There are over 50 different combinations of HRT currently available. Most women will make their choice over whether to take HRT, and which form, with the help of their GP”.2

Who is a GP?

DotS and/or DotC (Depending on the Country) a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Uterus or No UterusHormone Therapy Types

Is the type of HT prescribed for women with a uterus different from the type of HT prescribed for women without a uterus?

Yes. On page one in Deciding About Hormone Therapy Use the North American Menopause Society (NAMS) elaborate on:

“Hormone therapy involves taking estrogen in doses high enough to raise the level of estrogen in your blood in order to treat hot flashes and other symptoms. Because estrogen stimulates the lining of the uterus, women with a uterus need to take an additional hormone, progestogen, to protect the uterus. Women without a uterus just take estrogen. If you are bothered only by vaginal dryness, you can use very low doses of estrogen placed directly into the vagina”.3

Uterus

What type of HT may be prescribed for women who have a uterus?

In Hormone Help Desk: ET, EPT, and More – Estrogen-Progestogen Therapy (EPT) the NAMS explain:

Hormone Therapy Types“Women with a uterus who wish to use estrogen for symptom relief should combine it with a progestogen to protect the lining of the uterus (endometrium). Estrogen stimulates the uterine lining and causes it to thicken, increasing risk for endometrial cancer (cancer of the lining of the uterus). Progestogen is used to decrease the risk caused from ET, but does not protect against the type of uterine cancer that that is unrelated to estrogen. EPT is associated with side effects similar to ET and should be used at the lowest effective dose consistent with treatment goals. The risk of breast cancer appears to be higher with EPT, especially when used long-term (more than 5 yrs)”.4

No Uterus

What type of HT may be prescribed for women who do not have a uterus?

In Hormone Help Desk: ET, EPT, and More – Estrogen Therapy (ET) the NAMS elaborate on:

Hormone Therapy Types“Therapy with estrogen alone is generally appropriate only for women who have had a hysterectomy and do not need any uterine protection in the form of progestogens (either as natural progesterone or synthetic progestin) to prevent uterine cancer”.5

Health Care Provider

How do I find out what type of HT to use?

If you would like to find out what type of HT to use, it may be in your best interest to talk to your health care provider about this.

One of the points of consensus about menopausal hormone therapy (MHT) in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “The option of MHT is an individual decision in terms of quality of life and health priorities as well as personal risk factors such as age, time since menopause and the risk of VTE, stroke, ischemic heart disease and breast cancer. MHT should not be recommended without a clear indication for its use”.6

What is VTE?

VTE can be an abbreviation for Venous Thromboembolism.

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Sources

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Sources

  1. HRT: Which HRT? Reviewed: December 2017. Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/hrt/ Accessed: 15 May 2020
  2. HRT: Which HRT? Reviewed: December 2017. Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/hrt/ Accessed: 15 May 2020
  3. Deciding About Hormone Therapy Use. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 15 May 2020
  4. Hormone Help Desk: ET, EPT, and More – Estrogen-Progestogen Therapy (EPT). North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-help-desk-et-ept-and-more Accessed: 15 May 2020
  5. Hormone Help Desk: ET, EPT, and More – Estrogen Therapy (ET). North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-help-desk-et-ept-and-more Accessed: 15 May 2020
  6. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT. Climacteric, 2016;19:4:314 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 15 May 2020
Topic Last Updated: 21 May 2020 – Topic Last Reviewed: 15 May 2020
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