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When a woman passes through menopause either naturally or induced by surgery, drugs, or radiation, her sex hormone levels are lower, leading to potential problems of hot flashes, night sweats, dry vagina, incontinence, and decreased interest in sex, as well as increased risk of heart disease and osteoporosis.

The sex hormones produced in the body are estrogen, progesterone, and testosterone.

Estrogen Replacement Therapy, (ERT), is then typically considered to provide help. The amount of estrogen medication prescribed is not enough to be a replacement as it is only a small fraction of the amount of estrogen that the ovary usually produces.

When the uterus is present, it is essential that progesterone must also be replaced, sometimes with progesterone vaginal suppositories or (in some countries outside the U.S.) progesterone tablets, but most often with tablets of 'progestin' (a synthetic progesterone).

When progesterone or progestin is added to estrogen, this is called 'hormone replacement therapy' (or HRT for short).

This addition of progesterone or progestin prevents any increase in the risk of uterine cancer from estrogen.

ERT and HRT are sometimes used incorrectly or interchangeably by the media as well as by health care providers contributing to confusion.

Even women who have had a hysterectomy can benefit from progestogen since several studies show that full HRT can reduce the risk for breast cancer.

Some women under special circumstances and good supervision, take just estrogen alone, but health care providers must monitor the uterus of these women very carefully through endometrial biopsy and/or pelvic ultrasound.

Not only are these tests expensive, but the biopsy is invasive and may be painful during or after the procedure.

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