What Are the Pros and Cons of Different Types of Estrogen Replacement Therapy?
Once you have decided that you want to consider estrogen replacement therapy (ERT), there are more decisions to make on the horizon. Estrogen can be availed in different forms including pills, patches, and vaginal suppositories.
Pills
Pills and tablets are the most common forms of hormone replacement therapy. For many women, oral medication is the easiest way to avail of treatment. Doctors may prescribe estrogen-only or combined HRT pills to the patients.
Pros
Estrogen pills are very effective against the symptoms of menopause.
Balancing levels of estrogen in the body can also combat osteoporosis and associated symptoms.
Multiple studies have shown that oral pills are the most hassle-free method to intake estrogen.
Oral medication is also the most thoroughly studied form of estrogen therapy. There are newer HRT methods available but most are not as well researched.
Cons
If the estrogen levels in the body are not regulated, it may lead to an increased risk of strokes and blood clots. When taken with progestin supplements, it may even elevate the risk of breast cancer and heart attack.
Sometimes, estrogen therapy can be linked to side effects like swollen breasts, vaginal discharge, nausea, and headache.
In the presence of certain other medications, estrogen pills may not be well-absorbed, causing stomach issues.
Physicians also advise people with a weakened liver against oral estrogen intake since it can be hard on the liver.
Skin Patches
Skin patches, as the name suggests, are another type of estrogen replacement therapy where a patch containing estrogen is stuck to the skin. Other than estrogen-only patches, combination patches containing estrogen and progestin are also available. Ideally, the patches should be worn below the waistline or on the lower stomach region. You will need to change the patches once or twice every week.
Pros
A skin patch is extremely convenient. This is especially useful for people who tend to forget their pills. You can simply stick on the patch and go about your day.
Estrogen patches are also best suited for people with liver problems. In a patch, the estrogen no longer needs to be metabolized in the liver and can enter the bloodstream directly.
Some studies also revealed that patches are less likely to pose the risk of blood clots.
Cons
If you wear an estrogen patch, you will also be asked to avoid exposing the patch to direct sunlight or high heat. This includes hot baths, sauna, and tanning beds. When the skin patch encounters heat, it begins secreting the estrogen way too quickly, resulting in abnormal doses.
Apart from staying clear of heat and sunlight, an estrogen patch has all the cons of regular estrogen pills.
Topical Creams, Gels, and Sprays
Estrogen gels, creams, and sprays are applied to the skin, from where it gets absorbed into the bloodstream. Usually, gels are applied to the arm and creams to the legs. Sprays are applied to the arm as well.
Pros
Creams, gels, and sprays are ideal for people with cholesterol or a weak liver. The estrogen enters the bloodstream directly, forgoing metabolism in the liver.
Cons
Estrogen gels, creams, and sprays can rub or wash off before they are fully absorbed. Make sure the area is dry before you put on clothes. Stay away from water lest the estrogen washes away. You should also avoid heavy exercise that can make you sweat.
This ERT method is not very well studied. Some speculate gels, creams, and sprays are a safer alternative to pills but not enough research is present to back it up.
Vaginal Rings, Creams and Other Suppositories
Vaginal suppositories, rings, and creams are administered directly to the vaginal region. These are a very common treatment for women facing vaginal dryness, itching, pain, and burning. Vaginal rings need to be replaced once every quarter. Tablets, on the other hand, are to be used daily for 2 weeks, following which they should be used only twice a week.
Pros
Vaginal rings and suppositories only affect the immediate area without risking the entire body to high levels of estrogen.
Patients claim this method of ERT to be most effective against symptoms of menopause like dryness, hot flashes, and pain during intercourse.
Cons
Vaginal ERT is not recommended for women who still have their uterus lest it up the risks of endometrial cancer.
The Broadway Clinic offers a bio-identical estrogen replacement therapy for women whose ovaries are no longer able to naturally produce healthy amounts of estrogen. Our BHRT treatment lowers the risk of cardiovascular disorders and protects against osteoporosis. It also relieves other symptoms like hot flashes and fatigue. To book an appointment with us visit our website’s contact us section.
**Disclaimer: This content does not aim to provide any medical advice nor does it constitute or prescribe any doctor-patient relationship.