ERT vs HRT

Estrogen replacement therapy (ERT) and hormone replacement therapy (HRT) are hormone therapies prescribed for menopausal women. ERT and HRT both relieve symptoms of menopause such as mood swings, hot flashes, and vaginal symptoms that result from irregular levels of normal hormones in the body such as estrogen.

Previously, HRT only referred to ERT. Later on, HRT contained both estrogen and progestin. Progestin is important to prevent the occurrence of endometrial cancer. It keeps the endometrium from thickening. Estrogen, if taken alone, can increase the risk of developing endometrial cancer. HRT is prescribed for women who still have their uterus. Progestin is also termed as progestogen. Progestogen simulates the same effects with progesterone even though it doesn’t have progesterone content. It can be derived from testosterone and not solely from progesterone. HRT regimens include intermittent combined HRT, cyclic HRT, continuous combined HRT, and continuous cyclic HRT. They are used depending upon the woman’s condition. Progestogens are available in different forms such as creams, intrauterine device (IUD), Pill, vaginal capsules in peanut oil, or injections.

Whenever estrogen is needed alone, ERT is the therapy used. ERT, or unopposed estrogen, is the basic hormone replacement therapy for women who had their uterus removed such as those who have undergone a hysterectomy. ERT may contain the urine of mares that are pregnant. This form is termed as conjugated estrogens. Conjugated estrogens are more powerful than those ERTs made in the laboratory such as esterified estrogens, Estradiol, and Estropipate. Estrogens are available in many different forms such as vaginal creams, patches, shots, implants, tablets/pills, and vaginal ring inserts.

Although made to relieve symptoms, ERT and HRT also have their disadvantages and side effects. The following may be experienced by women under ERT and HRT: dizziness, changes in the corneal shape, cramping, uterine bleeding which includes monthly periods for some months, headache, increased density of the breast, breast tenderness, fluid retention, or bloating of the abdomen. Estrogen may cause an increase in weight during use. Natural progestogens have fewer side effects than the synthetically made progestogens. Synthetic progestogens may lead to worse conditions such as epilepsy, depression, migraines, heart failure, and asthma. Side effects of the therapy depend upon the woman taking it. Some women who are taking ERT/HRT may experience side effects because they still must adjust to the hormones. A three-month trial is done by the physician to observe the patient. Levels of hormones are adjusted to manage the symptoms.

Aside from the above-mentioned advantages of using ERT and HRT, it also prevents the occurrence of bone loss although it is not proven to decrease fractures. Taking ERT and HRT may improve levels of cholesterol.

The risks of taking ERT and HRT include high risks of developing heart attacks, increased triglycerides, the risk of breast cancer especially if used for a long time, as well as increasing the risk of ovarian cancer, blood clots, stroke, and may slightly augment the risk of having gallstones.

Women who use HRT must be screened for their overall health condition, willingness to experience the symptoms, and the severity of their symptoms. If the symptoms of menopause affect the ability to perform the activities of daily living, then HRT is recommended. Normally, ERT/HRT are taken only for three to five years. Tapering off is needed if taken for more than the recommended period of time. HRT is not given to women who are pregnant, have liver disease, a history of stroke or heart attack, who have unknown uterine bleeding, and who have past blood-clotting disorders.

Summary:

1.Estrogen replacement therapy (ERT) and hormone replacement therapy (HRT) are hormone therapies prescribed for menopausal women.

2.ERT and HRT both relieve symptoms of menopause such as mood swings, hot flashes, and vaginal symptoms that result from irregular levels of normal hormones in the body such as estrogen. It also prevents the occurrence of bone loss although it is not proven to decrease fractures. Taking ERT and HRT may improve levels of cholesterol.

3.HRT refers to a combination of estrogen and progestin, whereas ERT refers to estrogen only. HRT is recommended for women who still have their uterus. On the other hand, ERT is for those who have had a hysterectomy (removal of the uterus).

4.The following maybe experienced by women under ERT and HRT: dizziness, changes in the corneal shape, cramping, uterine bleeding which includes monthly periods for some months, headache, increased density of the breast, breast tenderness, fluid retention, or bloating of the abdomen.

5.Synthetic progestogens may lead to worse conditions such as epilepsy, depression, migraines, heart failure, and asthma.

6.Risks of taking ERT and HRT include: a high risk of developing heart attacks, increased triglycerides, the risk breast cancer especially if used for a long time, as well as increasing the risk of ovarian cancer, blood clots, stroke, and may slightly augment the risk of having gallstones.

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