ဟော်မုန်းအစားထိုးကုထုံး (HRT)

Menopause is the next big change in a women’s life after passing through the adolescence and reproductive stages. In case a menopausal woman has many of symptoms or conditions and needs hormone replacement, a doctor will make the decision about what hormones are necessary for the patient.


Hormone replacement
 refers to the use of bio-identical hormones that are chemically identical to those produced in a woman’s body. Replacement of estrogen is always done in combination with progesterone, and both have the same effect as natural ones.

Results of Hormone Replacement
  • Reduce depression, fatigue, shiver, difficulty sleeping.
  • Improve skin moisture, reduce skin inflammation, thicker and shinier hair.
  • Improve concentration and memory.
  • Increase bone density when taken together with calcium and proper exercise.
The results of hormone replacement are different from one woman to another, based on several different health factors. 

Hormone replacement can be done in the following ways: 

  • Hormone replacement after hysterectomy
Supplement with estrogen alone. This hormone helps reduce menopause symptoms, and is available in tablet, gel and patch forms.
  • Hormone replacement for women with their uterus
Use a combination of estrogen and progesterone in order to prevent endometrial hyperplasia and endometrial cancer. This regimen can be divided into:
    • Cyclic regimen: Supplemental estrogen for 21 days, with the last 12 days adding progesterone. There are 7 days that hormones are not used, and the woman consistently has a period during these 7 days. This HRT program is recommended for women in transition years or the early stages of menopause.
    • Continuous combined regimen: Estrogen is supplemented daily in combination with progesterone in the same amount.  Woman who use this type of HRT will have no period. This regimen of hormone replacement is recommended for women who have been in menopause for more than 1 year.
  • Other hormone replacement (not estrogen or progesterone)
 These hormore replacements may also prevent and cure menopause symptoms in some women.  You should consult with your doctor to determine what hormones may work best for you.
  • Estrogen:
Estrogen is a hormone for controlling the reproductive system, playing a role in the maturation of a girl, menstruation, and conception. It also affects other parts of the body such as bones, blood vessels, heart, and brain. The majority of estrogen is made in the ovaries. A smaller additional quantity of estrogen is produced by peripheral tissues such as fat.
Ovaries start to produce estrogen when a girl reaches her puberty. In reproductive ages, a woman has highest level of estrogen. Ovaries produce less estrogen when a woman reaches 40 years old and stop producing estrogen when she reaches menopause. The average age of Thai woman to reach menopause is 45 – 51 years, often slightly earlier than Western women.
If both ovaries have been removed before menopause, types of changes in the body are the same as a standard menopause, but likely to be more serious because of the abruptness of the estrogen deficiency.
There are many types of estrogen in hormone replacement. The most popular one is bio-identical hormone. Hormone replacement is available in tablet, gel, patch, or vaginal ring forms. A doctor will make the decision which form is most suitable for each patient. 
  • Progesterone:
Menopausal women need progesterone hormone mainly to prevent endometrial hyperplasia and endometrial cancer. Progesterone blocks DNA systhesis, cell division, and reduces estrogen
receptors. There are many types of natural progesterone. To prevent endometrial hyperplasia in women who receive estrogen replacement, the dose and duration of progesterone supplementation are important, and given only when necessary.
  • Vaginal bleeding frequently occurs, and causes some women to stop using the HRT program. This mostly occurs during the first 3 – 6 months, and after consistent use of the HRT, vaginal bleeding will disappear.
  • Breast pain appears only in the early days of receiving hormone replacement. The woman will feel less pain as time goes on, and the pain will eventually disappear.
  • Migraine headaches.
  • Weight gain: Most menopausal women easily gain weight. Hormone replacement by itself does not make a woman gain more weight. It is the woman’s daily life, especially the imbalance of eating, exercise, and slower metabolism, which causes most weight gain.
Hormone replacement is given in quantities as low as the normal physiologic level, thus side effects are not frequent or long lasting.

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