Everyone experiences hormonal decline as they age. For the few men and women for whom this occurs without symptoms, count yourselves fortunate. But for the estimated 90% of women who experience symptomatic menopause and the millions of men who develop low T, hormonal change can create uncomfortable physical, emotional, and even cognitive effects.
If your life is negatively impacted by hormonal decline or fluctuation, learning about the benefits of hormone replacement therapy (HRT) and how to evaluate the risks is critical. Knowing where to turn for advice and understanding your options may mean the difference between long-term discomfort and feeling like yourself again.
Recognizing the Symptoms of Hormonal Change
Hormones can deeply affect physiological and psychological health in both women and men.
Though each woman’s experience is different, symptoms like hot flashes, night sweats, changes to vaginal and surrounding tissues, and mood swings are common during both perimenopause and menopause. Many women also experience body composition changes that include abdominal weight gain and the loss of lean muscle mass. Meanwhile, loss of bone mineral density increases the risk of osteoporosis and can leave you vulnerable to fractures.
Testosterone deficiency can occur at any age, but it becomes more common as you get older. Researchers have found that 40% of men over 45 experience low testosterone, but less than 5% are diagnosed and treated. In part, this is because the symptoms are often seen as a normal part of aging. But low T symptoms like loss of libido, moodiness, irritability, and loss of muscle mass, strength, and bone density should not be ignored. In addition to putting you at increased risk of cardiovascular disease and metabolic syndrome, low testosterone can seriously interfere with your sense of self and overall quality of life.
The Benefits of Hormone Replacement Therapy
HRT is often considered the gold standard when it comes to addressing hormone imbalances and fluctuations. The benefits of hormone replacement therapy include both symptom relief and long-term protection from a variety of health conditions.
Elimination of Symptoms
Hormonal health is intensely personal and may be hard to talk about. Many people downplay their discomfort and put off seeking help. But living with disruptive symptoms is unnecessary when safe and effective treatment is available.
Since symptoms are caused by hormonal deficiency, restoring your hormone levels can minimize or even eliminate them. For example, in testosterone deficient men, HRT has been found to “result in improvements in erectile function, low sex drive, and/or depressive symptoms.” Meanwhile, hormone replacement may improve mood, reduce anxiety, elevate sexual desire, and reduce hot flashes in women.
Depending on your individual experience, this can translate to:
- Improved quality of life
- Greater self-confidence
- Better relationships
- Enhanced professional performance
Without symptoms wearing you down, it can also be easier to stay active and maintain a healthy lifestyle.
Reduced Risk of Disease
Though it may not be outwardly evident, hormonal deficiencies can have long-term effects on a variety of body systems. HRT may slow the progression of these tissue changes and decrease the risk of serious health problems that become more prevalent with age.
- Body composition: HRT may slow the loss of lean muscle mass in men and the deposition of abdominal fat that occurs in women when hormones decline.
- Bone mineral density: HRT may help both women and men preserve bone mineral density and prevent fractures.
- Cardiovascular health: Though hormone replacement is not considered as primary prevention or treatment for cardiovascular disease, it may offer cardiovascular benefits to men and women. Research suggests that cardiovascular risks are minimized in women when HRT is initiated before the age of 60 or within 10 years of menopause.
While the benefits of hormone replacement therapy can be significant for patients of any age, they are particularly valuable for women who experience premature (before age 40) or early (between 40 and 45) menopause. Both premature and early menopause are associated with increased risk of cardiovascular disease, neurological disease, psychiatric disorders, osteoporosis, and early death. Timely hormone replacement therapy may help to prevent some of these outcomes.
Evaluating the Risks of HRT
While the benefits of hormone replacement therapy are plentiful, some people have risk factors that must be considered. These risk factors do not necessarily preclude you from using HRT but will help you and your doctor make smart decisions about the type, dosage, and duration of your treatment.
For women, HRT, like hormonal birth control, is associated with an increased risk of blood clots and stroke, particularly when administered orally. Other administration methods, such as the patch or pellets, may allow you to use HRT more safely. However, a personal or family history of breast cancer is a common reason to avoid HRT regardless of how it is administered. Careful evaluation of your individual situation will help you and your doctor decide if the risks outweigh the benefits.
Men who have a high hematocrit levels may not be good candidates for HRT, as testosterone may cause an increase in red blood cells that could be dangerous. Men who have a history of prostate cancer should also approach HRT with caution. Though not an absolute contraindication, you may require additional monitoring. Ideally, all men on HRT will undergo regular blood counts and prostate-specific antigen (PSA) testing.
The Best Treatment Is Personal
If you are experiencing symptoms of hormonal change, HRT could put you on the path to feeling like yourself again. Though it’s common to have questions about risks, the benefits of hormone replacement therapy outweigh those risks for most people. The key is finding a knowledgeable and compassionate doctor who can evaluate your individual situation and help you determine whether treatment should include hormone therapy.
Regardless of whether you decide HRT is right for you, successful treatment for hormone deficiency or natural decline should be personal. That means you and your doctor should work closely together to create a plan that makes sense for you, taking into account your symptoms, medical history, and treatment goals. The plan should include lifestyle recommendations to support general health and regular follow-up care to track your progress. With the help of a hormone health expert, you can ensure that you are not only feeling better now, but supporting greater future health.