Hormone replacement therapy (HRT) involves taking medications or supplements to add hormones that your body no longer makes enough of on its own. It is often used to help alleviate uncomfortable menopause symptoms in women or hypogonadism symptoms in men. However, there are some potential downsides to consider before starting HRT:
- Increased risk of blood clots - HRT with estrogen can raise your risk of developing dangerous blood clots in your legs or lungs. The risk seems to be highest if you take oral estrogen. Using transdermal estrogen patches or gels may lower this risk.
- Higher chance of stroke - Several research studies have found that HRT containing oral estrogen boosts your stroke risk by up to 41%. This is especially true if you start HRT more than 10 years after menopause. Talk to your doctor about whether the benefits of relief from menopause symptoms outweigh the increased risk of stroke for you personally.
- Breast cancer - Data show that 5 years of HRT with combined estrogen and progesterone raises breast cancer likelihood up to 71%. Using estrogen alone for extended periods may pose less risk. Talk with your doctor about getting regular screenings.
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- Other cancers - Evidence links HRT use to increased risk of ovarian cancer and, potentially, other types. However, data are mixed.
- Gallbladder issues - Some research finds HRT can raise the likelihood of needing your gallbladder removed. About 6 in every 1,000 women who take oral estrogen may experience this. Again, skin patches/gels may reduce risk.
- Mental health issues - While HRT often improves mood and energy, it has been linked to new or worsening depression or anxiety in some. If you have a history of mental illness, discuss carefully with your doctor. Stopping HRT can also trigger symptoms abruptly if not tapered off slowly.
- Medication interactions - Estrogen can change the way some other drugs are processed and cleared from your body. This includes certain antidepressants, blood thinners, and migraine/seizure meds. Provide your prescribing doctor a full list of everything else you take to reduce issues. Get regular bloodwork to check levels and kidney/liver function. Your HRT may need adjusting.
- Potential for withdrawal symptoms if stopping HRT - Symptoms like hot flashes, trouble sleeping, irritability, and fatigue may return quickly and more severely if HRT is stopped without tapering off slowly under medical guidance. Never quit cold turkey without consulting your doctor.
- Need for lifelong treatment - Most experts advise continuing HRT as long as relief of menopause/andropause symptoms outweighs health risks for you. You'll likely need blood tests, health checks, and dosage adjustments over time. Your situation may change. Maintain an open dialogue with your doctor. Make sure you can commit to ongoing management.
- Out of pocket costs - Without insurance coverage, paying retail for HRT meds and related care/ monitoring can be pricey over time. Comparison shop pharmacies or order online. Ask your doctor for savings cards. Consider cheaper generic versions once stable on your regimen.
- Trial and error - Finding your optimal hormone therapy can involve trying different delivery methods and adjusting dosages until bothersome symptoms subside with acceptable side effects. Give each regimen 3 months unless bad reactions occur. Be patient with some ongoing tweaks.
Research all your options thoroughly. Discuss benefits vs downsides at length with a medical pro. Report concerning changes promptly. Commit to necessary follow-up care. With diligence and a good support team, hormone therapy provides long-term relief to many people.
