Hormone fluctuations during menopause - specifically of the female sex hormones progesterone and estrogen - is the primary cause of menopause symptoms. Hormone replacement therapy (HRT) is a treatment used to relieve menopause symptoms by supplementing the hormones a woman's body produces in very low levels after menopause. There has been controversy surrounding HRT over the last several years, but more research is being done to help people better understand the impacts of HRT. However, little is known about HRT's impact on fatigue.
How HRT Works and Its Benefits
HRT uses estrogen or a combination of estrogen and progesterone, depending on the woman. Women that have not had a hysterectomy - that is, those who still have their uterus - typically take a combination of estrogen and progesterone. Women who have had a hysterectomy normally receive only estrogen. HRT comes in various forms: oral tablets, skin patches, vaginal creams, vaginal rings, and topical gels. There are many different forms of HRT that deliver different hormones in different dosages, so it is important to talk to your doctor about which type is right for you.
The main benefit of HRT is that it is effective in managing menopause symptoms like hot flashes, vaginal dryness, loss of libido, and mood swings. HRT may also help prevent osteoporosis because the increase in estrogen helps maintain bone density. In general, doctors recommend that patients who choose HRT take the lowest dose possible for the shortest amount of time, usually around six months, because of the risks linked to HRT.
There is not much research that has connected fatigue and menopause, so it is difficult to say if hormone changes are responsible for fatigue. If they are responsible for fatigue, HRT may be able to help, but research needs to be done to support or disprove this. It is important you talk to your doctor about exactly what your menopausal symptoms are in order to find the best way to treat them.
A Choice That's Right for You
The studies on HRT that have gained the most attention highlight the risks of HRT. Many of these studies were done on women past menopause who had been taking HRT for an extended period of time. Hormone replacement therapy can increase the risk of heart disease, stroke, breast cancer, ovarian cancer, and blood clots. Because HRT effects people of different ages and with different risk factors in divergent ways, the findings of these studies may not apply to you. However, if you or a family member has a history of one of the conditions HRT increases the risk for, it is usually not recommended that you take hormone replacement therapy.
It is important to talk to your doctor before you start HRT so you can weigh your risk factors and menopausal symptoms and make a choice that is right for you. More research needs to be done to see how hormone replacement therapy influences the treatment of fatigue. However, HRT has been an effective method for managing the major symptoms of menopause.