HRT
Meaning of HRT: Three letters that in most conversations mean menopause, but that also cover thyroid, testosterone and gender-affirming treatment.
Definition of HRT
HRT stands for hormone replacement therapy: supplying a hormone the body no longer produces in sufficient amount. Used without qualification it usually means treatment with estrogen, a progestogen, or both after menopause, when the ovaries greatly reduce their output. The same three letters are also applied to thyroid, testosterone and gender-affirming hormone treatment.
What does menopausal HRT involve?
Falling estrogen after the ovaries wind down produces hot flushes, night sweats, disturbed sleep, mood changes and thinning and dryness of vaginal tissue. Replacing estrogen addresses these directly. A second hormone is added for anyone who still has a uterus, because estrogen alone causes the lining of the uterus to thicken and raises the risk of cancer of that lining, whereas adding a progestogen prevents that thickening. The word covers both natural progesterone and the manufactured versions called progestins, which are not identical in their effects. Vaginal preparations act locally with very little absorbed into the rest of the body.
What forms does it take?
| Form | How it is used |
|---|---|
| Tablet | Taken by mouth; passes through the liver before reaching the circulation |
| Patch or gel | Absorbed through the skin, bypassing that first pass through the liver |
| Vaginal cream, tablet or ring | Local effect on vaginal and urinary tissue |
| Implant or intrauterine device | Longer-acting delivery of estrogen or of a progestogen |
The route is not a cosmetic choice. Passing through the liver changes how the body handles clotting proteins, which is one reason oral and skin routes differ in their effects beyond the symptoms treated.
Why is the terminology shifting?
Replacement is a slightly misleading word, since the aim is not to restore levels present before menopause but to relieve symptoms with the smallest effective amount, and menopause is a normal stage rather than a deficiency disease. For that reason menopausal hormone therapy has become the preferred term in professional writing, while HRT remains the phrase most people use. The balance of benefits and harms depends heavily on age, time since menopause, the route used and a person's own medical history, and it has been revised repeatedly as long-term studies have been reanalyzed.
Also known as
Used in a sentence
HRT was discussed as an option for managing the patient's menopausal symptoms.
Good to know
Estrogen given alone thickens the lining of the uterus and raises the risk of cancer of that lining, which is why a progestogen is combined with it for anyone who still has a uterus, making uterine status central to the type of HRT used.