Healthcare provider explaining to patient how hormone replacement therapy works

How Does Hormone Replacement Therapy Work?

Written on December 22, 2023 by Jordan Stachel, MS, RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Hormone replacement therapy is the use of medications containing female hormones. Many people wonder, how does hormone replacement therapy work? Read this article for everything you need to know.

What Is Hormone Replacement Therapy?

Hormone replacement therapy (HRT) is the administration of medication containing female hormones. This is typically used for women who are going through menopause, as they can supplement with additional estrogen and/or progesterone to help manage menopausal symptoms.[1] During menopause, hormone levels shift, and the body can stop making estrogen and progesterone. Using HRT can be helpful for many women during this time to help reduce symptoms like hot flashes and/or vaginal discomfort.[1]

Estrogen is needed for several important functions in the body, including [2]:

  • The thickening of the lining of the uterus
  • The use of calcium in the body
  • Maintenance of cholesterol levels
  • Optimization of bone health

Progesterone is needed for several important functions as well, including [2]:

  • Preparing the body to fertilize an egg
  • Regulating blood pressure
  • Optimizing mood and sleep patterns

Types of HRT

Typically, as some women transition into menopause, they may begin HRT. There are two main types of HRT for women, either estrogen therapy or estrogen and progesterone (progestin hormone therapy) [2]:

  • Estrogen therapy: In this type of therapy, a woman takes estrogen alone. It may be taken as a cream, vaginal ring, gel, or spray.
  • Estrogen progesterone therapy: This is a combination therapy that involves taking both estrogen and progesterone.

HRT works by releasing these different types of hormones into the bloodstream and allowing them to travel to the organs where they are needed.[3] Depending on the mode of administration, these hormones may also be released directly into the tissue. HRT is something that needs to be taken daily in order to remain effective.

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Who Needs HRT?

Choosing to begin HRT is a personal decision that should be made by a woman and her healthcare provider. HRT may be helpful for some and not needed for others. There are some signs and symptoms to watch out for that may signify that HRT could be helpful, including [4]:

  • Disruptions in sleep patterns
  • Hot flashes
  • Joint or body aches
  • Feelings of low energy
  • Feeling out of control of your emotions
  • Additional general discomfort

If you or someone you know is experiencing these symptoms, it is important to seek care from a healthcare provider. They can help to create a treatment plan to help optimize some of these symptoms and feelings. Generally, if symptoms of menopause are interfering with your ability to have quality of life, are interfering with productivity, or are getting in the way of you enjoying activities of daily living, it is worth discussing HRT or alternative options further with a healthcare provider.[4]

Benefits of HRT

As with any medication, there are benefits and risks. For some women, the benefits of doing HRT may outweigh the risks. Some of these benefits include [5]:

  • Bone health: There is research to suggest that HRT can aid in protecting women’s bones. As women age, bone health can suffer, putting some women at a greater risk of osteopenia or osteoporosis. HRT can aid in reducing the risk of fractures.
  • Brain health: HRT may aid in optimizing cognition due to the protective factors it has on the nerve cells. When women begin to start making less estrogen, this can impact the brain’s ability to use glucose. As a result, the brain begins to use fats for fuel. For some people, this switch may not be helpful if it sacrifices white matter from the brain. However, the research indicates that HRT is only helpful in this regard if women begin it before menopause, rather than after menopause has started. On the contrary, a ketogenic diet may be helpful for postmenopausal women who did not begin HRT pre-menopause.

Risks of HRT

There is some research to indicate that HRT can affect stroke, blood clotting, and cancer risk.[5] A person’s risk depends on many different factors, including the type of hormones taken and the delivery method of these hormones. If you or someone you know is considering HRT, it is always best to consult a qualified healthcare provider for personalized guidance. What might be right for one person may not be right for another.

Support Your Hormonal Health With Everlywell

At Everlywell, we combine the best in modernized, rigorous lab testing with easy-to-access, at-home medicine. We provide a range of blood tests, including several of our women’s health tests, that you can take from the comfort of your home. Your results will be analyzed in CLIA-certified labs and an experienced healthcare provider will deliver your results. Take control of your health and hormonal well-being today with Everlywell.

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  1. Hormone therapy: Is it right for you? Mayo Clinic. Published December 6, 2022. Accessed on December 19, 2023.
  2. Hormone therapy for menopause symptoms. Cleveland Clinic. Last reviewed June 28, 2021. Accessed on December 19, 2023.
  3. Hormone therapy for menopause. ACOG. Last reviewed August 2022. Accessed on December 19, 2023.
  4. What you should know about hormone therapy and menopause. Columbia University Irving Medical Center. Published February 9, 2023. Accessed on December 19, 2023.
  5. Hormone replacement therapy: Is it right for you? Cedars-Sinai. Published February 8, 2023. Accessed on December 19, 2023.
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