“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.

Hormone Therapy

What is hormone therapy (HT)?

DotS the definition of HT may vary. 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

The (United Kingdom) NHS’s (National Health Service) definition is:

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

The NAMS’s definition is:

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

Menopausal Hormone Therapy

What is menopausal hormone therapy (MHT)?

DotS the definition of MHT may vary. 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 HT?

No. ‘The pill’ or the oral contraceptive pill (OCP) is not the same as HT. 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

Hormone TherapyIs 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 published in November 2015, 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

Is 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”.13

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”.14

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”.15

The NHS note:

Hormone Therapy
“When deciding whether to have hormone replacement therapy (HRT), it’s important to understand the risks”.16

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”.17

On page two in Deciding About Hormone Therapy Use: Hormone Therapy Options published in June 2017, 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”.18

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”.19

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”.20

Health Topics A-Z

Where may I find Health Topics related to Hormone Therapy?

In Health Topics A-Z you may find:

Links

Where may I find Links related to Hormone Therapy?

Your Country may have Links similar to:

Sources

Where may I find the Sources quoted above?

You may find the Sources at:

Sources

  1. Deciding About Hormone Therapy Use: Potential Benefits. 2017:1. North American Menopause Society http://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 06 August 2019
  2. Hormone Help Desk: ET, EPT, and More – Hormone Therapy (HT). North American Menopause Society http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-help-desk-et-ept-and-more Accessed: 06 August 2019
  3. Menopause Management: Menopausal Hormone Therapy (MHT) – What Is MHT? Last Updated 16 July 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 06 August 2019
  4. Hormone Replacement Therapy (HRT): Overview. Page Last Reviewed: 20 July 2016 NHS (National Health Service) https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/ Accessed: 06 August 2019
  5. Menopause Glossary: H – Hormone Therapy (HT). North American Menopause Society http://www.menopause.org/for-women/menopause-glossary#H Accessed: 06 August 2019
  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: 06 August 2019
  7. Sex & Relationships: Managing Contraception During Menopause – When Is It Safe To Stop Contraception? Last Updated 04 February 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/sex Accessed: 06 August 2019
  8. Deciding About Hormone Therapy Use: Potential Benefits. 2017:1. North American Menopause Society http://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 06 August 2019
  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 http://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 06 August 2019
  10. Hot Flushes and Night Sweats – Background Information: What Are Hot Flushes and Night Sweats? October 2011:1. International Menopause Society http://www.imsociety.org/downloads/world_menopause_day_2011/wmd_media_backgrounder.pdf Accessed: 06 August 2019
  11. Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? North American Menopause Society http://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 06 August 2019
  12. Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms. Published Date: November 2015. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Treating-menopausal-symptoms Accessed: 06 August 2019
  13. HRT: Which HRT? Reviewed: December 2017. Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/hrt/ Accessed: 06 August 2019
  14. Menopause: Hormone Treatments. Content Current As of: 11 March 2019. Food and Drug Administration https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117978.htm Accessed: 06 August 2019
  15. Women and Menopause: Maintaining Health and Vitality. October 2012:3. International Menopause Society http://www.imsociety.org/downloads/world_menopause_day_2012/wmd_general_menopause_backgrounder.pdf Accessed: 06 August 2019
  16. Hormone Replacement Therapy (HRT): Risks. Page Last Reviewed: 20 July 2016. NHS (National Health Service) https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/risks/ Accessed: 06 August 2019
  17. Menopause: Diagnosis & Treatment – Treatment. 07 August 2017. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 06 August 2019
  18. Deciding About Hormone Therapy Use: Hormone Therapy Options. 2017:2. North American Menopause Society http://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 06 August 2019
  19. 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 http://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 06 August 2019
  20. Menopause Management: Menopausal Hormone Therapy (MHT) – Should You Take MHT? Last Updated 16 July 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 06 August 2019
Topic Last Updated: 06 August 2019 – Topic Last Reviewed: 06 August 2019
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