Hormone replacement therapy (HRT) involves supplementing hormones that decline naturally with age. It is primarily used to treat symptoms of menopause in women and low testosterone in men.
The most common types of HRT are:
- Estrogen therapy - estrogen alone is given to women who have had a hysterectomy
- Progestogen therapy - progestogen alone is given to women with intact uteruses to protect against uterine cancer
- Combined HRT - both estrogen and progestogen are given to women with intact uteruses
- Testosterone therapy - testosterone is given to men with low testosterone
Referral and Evaluation
Before starting HRT, a full medical evaluation should be done. This typically involves:
- Medical history
- Physical exam
- Blood tests to check hormone levels
A referral to a specialist like an endocrinologist or menopause specialist may be warranted if the situation is complex. Specialist clinics like Butterfly Hormone Center have doctors experienced in providing customized HRT regimens to meet each patient's needs.
Hormone Administration
If HRT is appropriate, hormones can be administered in various ways:
- Oral tablets
- Skin patches
- Vaginal rings
- Injections
- Gels, sprays and creams applied to skin
The route used depends on the hormones being given and patient preference.
Estrogen
For
systemic estrogen therapy to treat menopause, the dose is adjusted based on the severity of symptoms and adjusted over time as needed. Women with
menopause caused by surgery or primary ovarian insufficiency may need higher doses.
The lowest effective dose should be used to manage symptoms. Common estrogen doses range from:
- Oral tablets: 1-2 milligrams per day
- Transdermal skin patches: 25-100 micrograms per day
Vaginal estrogen creams, tablets or rings deliver low doses directly to vaginal tissue. This treats
vaginal atrophy with fewer systemic effects.
Progestogen
In women with intact uteruses, progestogen must be given alongside systemic estrogen therapy. Getting proper
progesterone balance is critical for protecting the uterine lining.
Common progestogen regimens include:
- Cyclic - progestogen given 10-14 days per month
- Continuous - progestogen given daily
Butterfly Hormone Center Hormine Clinic specializes in personalized combined HRT with progestogen dosing tailored to each woman's needs.
Testosterone
For
testosterone replacement in men, treatment is started at lower doses like:
- Skin patches: 2.5-5 milligrams per day
- Gels: 50-100 milligrams per day
Levels are checked periodically and the dosage adjusted to keep testosterone levels in the normal range. Insufficient testosterone is supplemented to relieve symptoms like low energy, reduced muscle mass and
low libido.
Monitoring and Long-Term Care
Ongoing medical monitoring is important for safe, effective HRT. Follow-up visits should include:
- Assessing symptom relief
- Checking for side effects
- Testing hormone levels
- Screening for breast, cervical and endometrial cancer
Adjustments to medications can be made over months and years. Butterfly Hormone Center offers specialized long-term gender-affirming care, managing HRT through all stages of life.
In summary, modern forms of HRT can provide great relief, but must be administered carefully under medical supervision. Working with an experienced hormone therapy provider is key - contact Butterfly Hormone Center today to learn more!
