Hormone Therapy

“Hormone therapy is one of the most effective treatments available for bothersome hot flashes and night sweats. If night sweats are waking you throughout the night…”.1

Umbrella
What may the Hormone Therapy Umbrella include?

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

  • Hormone (Replacement) Therapy H(R)T
  • Hormone Medicines
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Hormones
  • Medicines for Hormone Replacement Therapy
  • Menopausal Hormone Therapy (MHT)
  • Menopause Hormone Medicines
  • Menopause Medicines

Date

What can it be important to be clear about with hormone therapy (HT) information?

I think it can be important to be clear about the date of all information including the date of HT information, because this information may have been updated.

Symptoms or Chronic Conditions

What can it also be important to be clear about with HT information?

I think it can also be important to be clear about whether HT information is about the use of HT for the management of menopausal symptoms such as hot flushes, night sweats and vaginal dryness or for the prevention of chronic conditions such as cardiovascular disease, cancer and osteoporosis.

Terminology

Are the terms hormone therapy (HT), hormone replacement therapy (HRT) and menopausal hormone therapy(MHT) the same?

Although the terms HT, HRT and MHT may be used interchangeably, I think they can also be like the terms diet, love and menopause and mean different things, to different people, at different times, in different places.

When I use the term HT what I mean may be different to what someone else means or what is meant in medicaltalk.

It can therefore be important when the term HT is used to be clear about what is meant, so we may work out whether we are on the same page meaning the same thing or not.

HT or HRT

Is HT the new HRT?

In Hormone Help Desk: ET, EPT, and More the North American Menopause Society (NAMS) explain:

“Hormone therapy (HT) – HT is another umbrella term your healthcare provider might use that refers to either ET or EPT. The term “hormone replacement therapy” is no longer used by the Food and Drug Administration (FDA) or The North American Menopause Society because the goal of HT is to provide the amount of hormones required to relieve symptoms, not “replace” the amount produced before menopause. It is considered normal to have low estrogen and progesterone after menopause. Menopause is not a deficiency disease”.2

ET

What is ET?

ET can be an abbreviation for Estrogen Therapy.

EPT

What is EPT?

EPT can be an abbreviation for Estrogen Plus Progestogen Therapy.

Menopausal Hormone Therapy

What is menopausal hormone therapy (MHT)?

DotS the definition of MHT may vary. In Menopause Management: Menopausal Hormone Therapy (MHT) – What Is MHT? the (Australian) Jean Hailes for Women’s Health (JH) definition is:

“Menopausal Hormone Therapy (MHT), formerly known as Hormone Replacement Therapy (HRT) and hormone therapy (HT), is the medical replacement of the female hormones oestrogen and progesterone, and sometimes testosterone. MHT is a treatment used to help manage menopausal symptoms, such as hot flushes and night sweats, when they are interfering with your life”.3

In Hormone Replacement Therapy (HRT): Overview the (United Kingdom) NHS’s (National Health Service) definition is:

“Hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause. It replaces hormones that are at a lower level as you approach the menopause”.4

In Menopause Glossary: H – Hormone Therapy (HT) the NAMS’s definition is:

“Hormone therapy (HT). Prescription drugs used most often when treating menopause symptoms. Encompasses ET and EPT”.5

In Glossary of Terms: Menopausal Hormone Therapy (MHT) Hormone Replacement Therapy (HRT)/Hormone Therapy (HT) the Australasian Menopause Society’s (AMS) definition is:

“Menopausal Hormone Therapy (MHT)/Hormone Replacement Therapy (HRT)/Hormone Therapy (HT): MHT is when hormones are prescribed during the menopause transition and after the periods have stopped to alleviate oestrogen deficiency symptoms such as hot flushes, mood swings, vaginal dryness and to prevent or treat longer term diseases such as osteoporosis.

HRT/HT is now referred to as Menopausal Hormone Therapy (MHT)”.6

The Pill

Is the pill the same as MHT?

No. ‘The pill’ or the oral contraceptive pill (OCP) is not the same as MHT. The JH caution:

“Please note that MHT is not a contraceptive”.7

Effective or Not

Is HT effective?

On page one in Deciding About Hormone Therapy Use: Potential Benefits published in June 2017, the NAMS note:

“Hormone therapy is one of the most effective treatments available for bothersome hot flashes and night sweats. If night sweats are waking you throughout the night, HT may improve sleep and fatigue, mood, ability to concentrate, and overall quality of life. Treatment of bothersome hot flashes and night sweats is the principal reason women use HT. Hormone therapy also treats vaginal dryness and painful sex associated with menopause. Hormone therapy keeps your bones strong by preserving bone density and decreasing your risk of osteoporosis and fractures. If preserving bone density is your only concern, and you do not have bothersome hot flashes, other treatments may be recommended instead of HT”.8

Benefits and Risks

When are MHT benefits more likely to outweigh risks?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “MHT, including tibolone and the combination of conjugated equine estrogens and bazedoxifene (CE/BZA), is the most effective treatment for vasomotor symptoms (VMS) associated with menopause at any age, but benefits are more likely to outweigh risks if initiated for symptomatic women before the age of 60 years or within 10 years after menopause”.9

What are VMS?

DotS the definition of VMS may vary. The IMS’s definition is:

“Hot flushes and night sweats are also referred to as Vasomotor Symptoms (VMS)”.10

Different Differences

Is HT one-size-fits-all?

No. HT is not one-size-fits-all because different women have different menopausal symptoms of different severity, for different lengths of time before and after their final menstrual period. In Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? the NAMS note:

“You should discuss your individual risks and preferences with your healthcare team to determine whether hormone therapy or alternatives, including FDA-approved nonhormonal therapies, are right for you”.11

What is FDA?

FDA can be an abbreviation for the (United States) Food and Drug Administration.

Common or Not

Is HT the most commonly prescribed treatment for menopausal symptoms?

Yes. In Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms the (British) National Institute for Health and Care Excellence’s (NICE) explain:

“For women who seek help for their menopausal symptoms, HRT (hormone replacement therapy) is the most commonly prescribed treatment. HRT helps to relieve symptoms by replacing oestrogen levels that naturally fall in menopause. You can take HRT as tablets or through a patch or gel on your skin.

If HRT is suitable for you and you are interested in taking it, your GP should discuss the benefits and risks with you, both in the short term (the next 5 years) and in the future, before you decide to start it.

You should also be given information about:

  • Non-hormonal treatments, for example a drug called clonidine
  • Other types of treatments, such as cognitive behavioural therapy (CBT), a type of psychological therapy that helps people to manage the way they think and feel”.12

Who is a GP?

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

Types

Are there different types of HT?

Yes. 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”.13

In Making Sense of Menopausal Hormone Therapy Means Understanding the Benefits As Well As the Risks: What Is Menopause Hormone Therapy? the author explains:

“Oestrogen is usually taken in tablet form, but can be applied as a skin patch or skin gel, or as a vaginal pessary. Progesterone is taken as a capsule. There are a range of single formulations and combinations, so the dose and formulation of MHT should be tailored to each woman’s health profile and personal preferences”.14

Dose, Duration and Follow Up

What does the FDA note about choosing to use HT?

In Menopause: Hormone Treatments? the FDA note:

“Menopause Hormone Therapy should always be used at the lowest dose that helps and for the shortest time that you need it”.15

Health Care Provider

What if I to choose to use HT?

If you choose to use HT, it may be in your best interest to also choose to talk to your health care provider about this. The IMS explain:

“Each woman is unique and must make her own informed decisions about her health”.16

In Hormone Replacement Therapy (HRT): Risks the NHS note:

Hormone Therapy
“When deciding whether to have hormone replacement therapy (HRT), it’s important to understand the risks”.17

In Menopause: Diagnosis & Treatment – Treatment the (United States) Mayo Clinic explain:

“Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change”.18

On page two in Deciding About Hormone Therapy Use: Hormone Therapy Options the NAMS elaborate on:

“Each woman must make her own decision about HT with the help of her healthcare provider. If you decide to take HT, the next step is to choose between the many HT options available to find the best dose and route for you. With guidance from your health care provider, you can try different forms of HT until you find the type and dose that treats your symptoms with few side effects”.19

Some other points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT are:

  • “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
  • Consideration of MHT for symptom relief or osteoporosis prevention should be a part of an overall strategy including lifestyle recommendations regarding diet, exercise, smoking cessation and safe levels of alcohol consumption for maintaining the health and quality of life of peri- and postmenopausal women”.20

What is VTE?

VTE can be an abbreviation for Venous Thromboembolism.

The JH also note:

  • “Jean Hailes recommends each woman discusses her decision about taking MHT with her doctor regularly and whenever there are any concerns”.21

Health Topics A-Z

Where may I find Health Topics related to Hormone Therapy?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Hormone Therapy?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

  1. 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy
  2. 5 of the Most Common Questions About Menopause: 1. Should I Start Hormone Therapy?
  3. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 6. Myth – Complementary Medicines and Therapies Are As Effective As MHT and Safer
  4. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 7. Myth – Compounded Bioidentical Hormone Therapy Is Safer Than Conventional MHT
  5. A Fresh Perspective on A Recurring Challenge Benefit-Risk Discussion
  6. BMS, IMS, EMAS, RCOG and AMS Joint Statement on Menopausal Hormone Therapy and Breast Cancer Risk In Response To EMA Pharmacovigilance Risk Assessment Committee Recommendations In May 2020 [17 January 2021]
  7. Bioidentical Hormone Therapy
  8. Bioidentical Hormones Explained – A British Menopause Society Video
  9. Bioidentical Hormones: Are They Safer?
  10. Bleeding – Perimenopausal, Postmenopausal and Breakthrough Bleeding on MHT/HRT
  11. Combined Menopausal Hormone Therapy (MHT)
  12. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  13. Compounded Bioidentical Hormone Therapy [Video]
  14. Deciding About Hormone Therapy
  15. Deciding About Hormone Therapy Use
  16. Decidir Sobre La Hormonoterapia
  17. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  18. Estrogen & Hormones: Estrogen and the Cardiovascular System
  19. Experts Rip Into HRT-Cancer Study
  20. HRT
  21. HRT and Bleeding Explained – A British Menopause Society Video
  22. HRT and Breast Cancer: Overall Risks and Benefits Explained – A British Menopause Society Video
  23. HRT and the Risk of Breast Cancer Explained – A British Menopause Society Video
  24. HRT: Benefits and Risks
  25. HRT: The History
  26. Hormone Help Desk: ET, EPT, and More
  27. Hormone Replacement Therapy
  28. Hormone Replacement Therapy (HRT)
  29. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  30. Hormone Replacement Therapy (HRT): Risks
  31. Hormone Replacement Therapy (HRT): Types
  32. Hormone Replacement Therapy Safe, Despite Rare Blood Clot Risks From Tablets
  33. Hormone Therapy
  34. Hormone Therapy: Is It Right for You?
  35. Hot Flashes: Manage Without Medication?
  36. Hot Flashes: What Can I Do?
  37. Hot Flashes? Night Sweats? Progesterone Can Help Reduce Symptoms of Menopause
  38. Information About Menopause [Multiply Languages] [Videos]
  39. Jean Hailes MHT Position Statement
  40. La Menopausia Y Las Hormonas: Preguntas Para Su Médico
  41. MHT and Breast Cancer Risk
  42. Making Choices At Menopause
  43. Making Sense of Menopausal Hormone Therapy Means Understanding the Benefits As Well As the Risks
  44. Managing Menopausal Symptoms After Breast Cancer – A Guide for Women [Booklet]
  45. Maori: What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  46. Mayo Clinic Q and A: Estrogen Replacement Therapy After Ovary Removal
  47. Mayo Clinic Q and A: Managing the Symptoms of Vaginal Atrophy
  48. Menopause
  49. Menopause
  50. Menopause
  51. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  52. Menopause Hormone Therapy: Does It Cause Vaginal Bleeding?
  53. Menopause Hormone Therapy: Follow-Up Appointments?
  54. Menopause Hormone Therapy: Who Shouldn’t Take It?
  55. Menopause Management: Menopausal Hormone Therapy (MHT)
  56. Menopause Matters
  57. Menopause Treatment
  58. Menopause – Fact Sheet
  59. Menopause – Is Menopausal Hormone Therapy (HRT) Safe? [Multiply Languages] [Video]
  60. Menopause – What Is Menopausal Hormone Therapy (HRT)? [Multiply Languages] [Video]
  61. Menopause: Diagnosis & Treatment – Treatment
  62. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  63. Menopause: Diagnosis and Management – Information for the Public: Starting and Stopping HRT [NICE Guideline]
  64. Menopause: Hormone Replacement Therapy (HRT) [Video Interview Stories]
  65. Menopause: Medicines To Help You
  66. Menopause: Menopause – Hormone Treatments
  67. Misinterpretation of WHI Results Decreased Use of Hormones, Even In Women Not At Risk [Women’s Health Initiative]
  68. Misperceptions From WHI Prevent Women from Benefitting from Hormone Therapy
  69. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  70. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  71. National Center for Complementary and Integrative Health: Know the Science: How Medications and Supplements Can Interact
  72. National Center for Complementary and Integrative Health: Menopausal Symptoms In Depth
  73. Non-Hormonal Treatment Options for Menopausal Symptoms
  74. NonHormonal Treatments for Menopausal Symptoms
  75. Oestrogen Only Menopausal Hormone Therapy
  76. Practical Prescribing Explained – A British Menopause Society Video
  77. Recent Review Confirms Safety of Low Dose Vaginal Estrogen: July 2019
  78. Risks and Benefits of MHT/HRT
  79. Safety of Vaginal Estrogens: A Recap of A Systematic Review [Video]
  80. Selective Serotonin Reuptake Inhibitors (SSRIs)
  81. Testosterone Explained – A British Menopause Society Video
  82. The International Menopause Society Comment on: “Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-Analysis of the Worldwide Epidemiological Experience”
  83. Tipos de Hormonoterapia
  84. Types of Hormone Therapy
  85. Understanding Menopause – Booklet
  86. Understanding Premature & Early Menopause – Booklet
  87. Urogenital Atrophy Explained – A British Menopause Society Video
  88. Using HRT (Hormone Replacement Therapy)
  89. Vaginal Dryness
  90. Vaginal Dryness
  91. Venous Thrombosis/Thromboembolism Risk and Menopausal Treatments
  92. Video Series-2018 – Moisturizers, Lubricants, and Prasterone
  93. Video Series-2020 – TSECs—A New Treatment for Hot Flashes and Night Sweats
  94. Video Series-2020 – What You Need To Know About Bioidentical Hormone Therapy
  95. Video Series-2021 – What Women Need To Know About Hormone Therapies
  96. What Is MHT and Is It Safe? Vietnamese: What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  97. Vulvovaginal Symptoms After Menopause
  98. What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  99. Women’s Wellness: Treating Hot Flashes Without Hormones [+ Video]
  100. World Menopause Day: World Menopause Day 2019 – Patient Information Leaflet: Testosterone for Women At Midlife [Multiply Languages]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Deciding About Hormone Therapy Use: Potential Benefits. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 14 January 2021
  2. Hormone Help Desk: ET, EPT, and More – Hormone Therapy (HT). North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-help-desk-et-ept-and-more Accessed: 14 January 2021
  3. Menopause Management: Menopausal Hormone Therapy (MHT) – What Is MHT? Last Updated: 07 December 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 14 January 2021
  4. Hormone Replacement Therapy (HRT): Overview. Page Last Reviewed: 09 September 2019 NHS (National Health Service) https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/ Accessed: 14 January 2021
  5. Menopause Glossary: H – Hormone Therapy (HT). North American Menopause Society https://www.menopause.org/for-women/menopause-glossary#H Accessed: 14 January 2021
  6. Glossary of Terms: Menopausal Hormone Therapy (MHT) Hormone Replacement Therapy (HRT)/Hormone Therapy (HT). Content Updated: January 2016. Australasian Menopause Society’s https://www.menopause.org.au/hp/information-sheets/381-glossary-of-terms Accessed: 14 January 2021
  7. Sex & Relationships: Managing Contraception During Menopause – When Is It Safe To Stop Contraception? Last Updated: 22 October 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/sex Accessed: 14 January 2021
  8. Deciding About Hormone Therapy Use: Potential Benefits. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 14 January 2021
  9. 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 A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 14 January 2021
  10. Hot Flushes and Night Sweats – Background Information: What Are Hot Flushes and Night Sweats? October 2011:1. International Menopause Society https://www.imsociety.org/downloads/world_menopause_day_2011/wmd_media_backgrounder.pdf Accessed: 14 January 2021
  11. Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 14 January 2021
  12. Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms. Published Date: 12 November 2015. Last Updated: 05 December 2020. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Treating-menopausal-symptoms Accessed: 14 January 2021
  13. HRT: Which HRT? Reviewed: December 2017. Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/hrt/ Accessed: 14 January 2021
  14. Davis, S. Making Sense of Menopausal Hormone Therapy Means Understanding the Benefits As Well As the Risks: What Is Menopause Hormone Therapy? 18 November 2019. https://theconversation.com/making-sense-of-menopausal-hormone-therapy-means-understanding-the-benefits-as-well-as-the-risks-124084 Accessed: 14 January 2021
  15. Menopause: Hormone Treatments. Content Current As of: 22 August 2019. Food and Drug Administration https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117978.htm Accessed: 14 January 2021
  16. Women and Menopause: Maintaining Health and Vitality. October 2012:3. International Menopause Society https://www.imsociety.org/downloads/world_menopause_day_2012/wmd_general_menopause_backgrounder.pdf Accessed: 14 January 2021
  17. Hormone Replacement Therapy (HRT): Risks. Page Last Reviewed:09 September 2019. NHS (National Health Service) https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/risks/ Accessed: 14 January 2021
  18. Menopause: Diagnosis & Treatment – Treatment. 14 October 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 14 January 2021
  19. Deciding About Hormone Therapy Use: Hormone Therapy Options. 2017:2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 14 January 2021
  20. 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: 14 January 2021
  21. Menopause Management: Menopausal Hormone Therapy (MHT) – Should You Take MHT? Last Updated: 07 December 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 14 January 2021

Topic Last Updated: 26 February 2021 – Topic Last Reviewed: 14 January 2021
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