How Do Estrogens/progestins-HRT Work?

Reviewed on 1/6/2022

How do estrogens/progestins-HRT work?

Estrogens/progestins-HRT medications are used as a hormone replacement therapy (HRT) to relieve menopausal symptoms in women. Estrogens/progestins-HRT medications are synthetic combination formulations of the natural female sex hormones progesterone and estrogen and have similar effects.

Estrogens are a group of endogenous hormones responsible for the development and maintenance of the female reproductive system and secondary sexual characteristics. Progesterone is the other female sex hormone that prepares the endometrium, the inner lining of the uterus, for implantation and continuation of pregnancy.

Endogenous estrogens are of three major types, estradiol, estriol, and estrone. Estradiol is the primary type of estrogen produced by the ovaries in premenopausal women. The fall in estradiol levels in perimenopausal women leads to symptoms such as hot flushes, and vaginal dryness, and atrophy.

Estrogens/progestins-HRT is used to supplement the depleted estradiol production, which relieves menopausal symptoms and prevents bone loss due to low estrogen levels. Progestins are added to protect women with an intact uterus from the risk of endometrial hyperplasia and cancer that can result from unopposed estrogen therapy.

Estrogens/progestins-HRT works by reducing the elevated levels of reproductive hormones in postmenopausal women, which include gonadotropin-releasing hormone (GnRH) from the hypothalamus, and follicular stimulating hormone (FSH), and luteinizing hormone (LH) from the pituitary gland.

SLIDESHOW

Pelvic Pain: What's Causing Your Pelvic Pain? See Slideshow

How are estrogens/progestins-HRT used?

Estrogens/progestins-HRT may be administered in the following ways:

  • Oral tablets or capsules are taken every day continuously, or in 28-day cycles during which withdrawal bleeding may occur
  • Transdermal patches applied on clean, dry, intact, and fold-free skin on the lower abdomen or upper quadrant of the buttocks

The recommended duration for estrogens/progestins-HRT is typically 5 years or less and not beyond 60 years of age. The uses of estrogens/progestins-HRT include:

FDA-approved:

Hormone replacement therapy for the treatment of:

  • Moderate to severe vasomotor symptoms (hot flushes) associated with menopause in women with an intact uterus
  • Vulvar and vaginal atrophy associated with menopause in women with an intact uterus
  • Hypoestrogenism (low estrogen levels) in women due to:
    • Hypogonadism (inadequate functioning of ovaries and sex hormone deficiency)
    • Primary ovarian failure
    • Removal of ovaries
  • Prevention of osteoporosis in postmenopausal women with an intact uterus

Off-label uses:

What are the side effects of estrogens/progestins?

Side effects of estrogens/progestins may include the following:

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with travel medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

QUESTION

Endometriosis occurs deep inside the uterus. See Answer

What are the names of estrogens/progestins-HRT drugs?

Generic and brand names of estrogens/progestins-HRT drugs include:

References
https://reference.medscape.com/drugs/estrogens-progestins-hrt

https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020375s026lbl.pdf

https://www.uptodate.com/contents/treatment-of-menopausal-symptoms-with-hormone-therapy

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