When your body can no longer optimally produce the necessary hormones for proper functioning, then hormone replacement therapy (HRT) can be done to get your endocrine system back to normal. This medical process includes the use of supplements or the replacement of certain hormones using injections and other treatment options. The specific types of HRT a patient needs will depend on their specific hormone deficiency, age, sex, medical history, and health goals.

If you’re curious about the different types of HRT, then you’re in the right place. In this article, we’ll be exploring the various categories, applications, benefits, and risks of hormone replacement therapy. 

Estrogen-Only Hormone Replacement Therapy

This treatment is done primarily for women who have had their uterus removed (hysterectomy). When a woman’s uterus is removed, there is no risk of endometrial cancer. Thus, it’s not compulsory to balance estrogen with progesterone. Estrogen-only HRT can prevent hot flashes, night sweats, vaginal dryness, and other menopausal symptoms. 

Forms

• Oral tablets: Taken daily.
• Patches: Applied to the skin weekly or bi-weekly.
• Creams, gels, and sprays: Applied and absorbed through the skin.
• Vaginal creams and rings: Can be used immediately to relieve vaginal symptoms like dryness.

Benefits

• It reduces the intensity of menopause-related health issues.
• It maintains bone density, which prevents osteoporosis.
• It can improve mood and reduce the risk of depression in some women. 

Risks 

• Increased risk of blood clots, stroke, and heart disease in older women.
• It has been linked with a greater risk of certain types of breast cancer when used long-term.
• Oral estrogen can cause headaches, nausea, vaginal discharge, swollen breasts, and might be hard on people with liver damage. 

Combined Hormone Replacement Therapy (Estrogen and Progesterone)

This type of HRT is done for women who still have their uterus. Progesterone is used alongside estrogen to prevent the thickening of the uterine lining, which can lead to endometrial cancer. Combined hormone replacement therapy can be recommended for women with moderate to severe menopausal symptoms.

Forms

• Cyclic combined or sequential HRT: Here, estrogen is taken daily, and progesterone is added at some point during the month. Monthly cyclical HRT requires that you take progesterone during the last 10-14 days of your menstrual cycle. Alternatively, in 3-month sequential HRT, you take progesterone for 10-14 days every three months. This type of HRT often leads to monthly withdrawal bleeding.
• Continuous Combined HRT: Estrogen and progesterone are taken daily with no monthly bleeding. It is prescribed to women who have not had a period for up to a year.

Benefits

• It prevents menopausal conditions like mood swings and flashes.
• It prevents osteoporosis and the risk of endometrial cancer.

Risks 

• Risk of breast cancer with long-term use.
• Side effects include bloating, breast tenderness, and mood swings.
• Increased risk of stroke and blood clots in older women.

Bioidentical Hormone Replacement Therapy (BHRT)

Bioidentical hormones are chemically similar to those your body naturally produces. They are usually derived from plant estrogens and are modified to suit someone’s individual hormone levels.

Forms

• Compounded Hormones: They are provided by pharmacies in creams, gels, and pills.
• FDA-Approved BHRT: They are available in the standard dose in the form of patches, gels, and creams.

Benefits

• They can serve as a more natural approach to hormone replacement.
• Some people experience fewer side effects when compared with other HRTs.
• It can relieve menopausal symptoms alongside boosting skin and hair health.

Risks 

• It can lead to stroke, blood clots, and certain cancers like breast and ovarian cancer.
• Its long-term safety is uncertain.
• Unregulated compounded BHRT is risky because it can lack dosing control.

Testosterone Replacement Therapy (TRT)

TRT is often taken by men with low testosterone caused by aging or a medical condition. It is also used in hormone therapy for transgender men undergoing female-to-male transition. It is important to note that testosterone is crucial to maintaining a man’s muscle mass, bone density, and sexual health.

Forms

• Gels and patches: To be applied to the skin daily.
• Injections: Given weekly or bi-weekly.
• Pellets: Inserted under the skin for testosterone to be released slowly over 3-6 months.

Benefits

• Increases muscle mass and reduces body fat.
• Improves energy levels and bone strength.
• Boosts sexual function.

Risks 

• Increased risk of blood clots due to rise in blood cell count.
• Possible enlargement of the prostate.
• Increased risk of stroke and heart disease if poorly monitored.

Selective Estrogen Receptor Modulators (SERMs) and Tibolone

SERMs function like estrogen in some parts of the body while blocking its effects in other parts. Also, tibolone is a synthetic hormone that mimics estrogen, progesterone, and estrogen. 

Forms

• Oral tablets: To be taken daily for both SERMs and Tiblone.

Benefits

• It can help with addressing menopausal symptoms and preventing bone loss without increasing the risk of breast or uterine cancer.
• Tibolone can help improve postmenopausal women’s mood and libido.

Risks 

• It might not effectively deal with hot flashes like other HRTs.
• Tibolone can increase the risk of breast and stroke in older women.

Hormone Replacement Therapy for Gender Transition

These types of HRT can help transgender people align physical characteristics with their gender identity. There are two main forms: feminizing hormone therapy administers estrogen and antiandrogen to transwomen while masculinizing hormone therapy involves prescribing testosterone to transmen. 

Forms

• Estrogen and anti-androgens: Available in oral pills, injections, and pellets.
• Testosterone: Administered as gels, injections, and pellets.

Benefits

• Helps transgender people get gender-affirming physical changes like breast development and facial hair.
• Reduces gender dysphoria.
• Improves mental well-being.

Risks 

• Long-term use increases the risks of blood clots, heart disease, and certain cancers.

Speak to a Medical Expert for a Proper Diagnosis

There’s no doubt that HRT can be tailored to improve the quality of life for so many people. This is especially true when they are experiencing hormone deficiencies due to aging, medical conditions, or gender transition. However, it comes with its risks. 

This is why it is important to weigh the advantages and disadvantages before starting treatment. It is advisable to speak with a medical expert to determine the best treatment for you. Additionally, keep in mind that with careful monitoring, HRT is a proven way to get the hormonal balance your body needs.