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
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.