Highlighting the Key Risks and Benefits of HRT

When assisting patients to make an informed decision about Hormone Replacement Therapy (HRT), it is essential for pharmacists to have a comprehensive understanding of the associated risks and benefits. By being well-versed in the potential risks and benefits of HRT, pharmacists can play a pivotal role in ensuring that patients are educated about the treatment options available. This knowledge will enable you to guide patients effectively and address any concerns. Inspired by our recent podcast on HRT, we have put together a short article which summarises these key risks and benefits that pharmacists need to be aware of.

The Key Benefits

Controls menopausal symptoms:

• HRT provides significant relief from menopausal symptoms such as hot flushes, night sweats, mood changes, brain fog, and vaginal dryness.

• Women typically experience improvement in these symptoms within a few weeks of initiating HRT. However, for maximum benefit, you should advise your patient to continue treatment for a few months.

• This reduction in symptoms is a crucial benefit to understand, as this is often the primary reason women consider HRT.

Protection from Osteoporosis:

• A second key benefit of HRT is the increased protection from Osteoporosis. This is because HRT raises Oestrogen levels, which aids in the prevention of bone loss and decreases the risk of developing Osteoporosis and subsequent fractures. This is a key benefit for patients to be made aware of.

Reduced risk of cognitive decline:

• Another key benefit of HRT is the reduced risk of cognitive decline. HRT has been associated with improvements in cognitive function and larger brain volumes.

• Research studies have suggested a potential protective effect of HRT against age-related cognitive decline and neurodegenerative diseases such as Alzheimer's disease.

• Oestrogen, one of the key hormones involved in HRT, plays a crucial role in maintaining brain health. It's important to have a comprehensive understanding of this in order to educate your patient fully.

In addition to these benefits, it is equally important to emphasise the potential risks of HRT to your patients and help them to understand the perspective of these risks. Therefore, we have outlined below the four key risks associated with HRT.

The Key Risks

Breast Cancer risk:

• An increased risk of Breast Cancer has been linked to HRT. This increased risk is related to how long the patient takes HRT, and it falls after they stop taking it.

• The risk increases the older a woman gets, and it is important that you ensure your patient is aware and counselled appropriately on this.

VTE (Venous Thromboembolism) risk:

• HRT has also been associated with an increased risk of VTE. It's crucial to note here that this risk is higher when using oral HRT compared to transdermal forms. Therefore, pharmacists should make their patients aware of this and opt for transdermal forms in women at higher risk of VTE. By doing this, you will provide your patient with the appropriate information to make an informed decision.

Ovarian Cancer risk:

• Another risk that has been linked with HRT is the increased risk of Ovarian Cancer. While data on this association is limited, it remains important to ensure that women are informed about the potential increased risk when making their decision.

Cardiovascular risk:

• One final key risk of HRT is increased cardiovascular risk. The risk of heart disease and strokes is increased for women on HRT who are above the age of 60. However, if a woman starts HRT before the age of 60, this risk does not increase.

• It is also important to make your patient aware that the cardiovascular risk is higher with oral HRT preparations.

In Summary

Understanding the key risks and benefits of Hormone Replacement Therapy (HRT) is vital for pharmacists to guide patients in making informed decisions. HRT offers significant relief from menopausal symptoms, protection against Osteoporosis, and a reduced risk of cognitive decline. However, it is important to educate your patient on the potential risks, including an increased risk of Breast Cancer, VTE, Ovarian Cancer, and Cardiovascular disease. By providing comprehensive knowledge and counselling patients, pharmacists can empower patients to weigh these factors and make choices that align with their individual needs and preferences.

If you would like to learn more, please listen to our latest podcast episode: 'HRT: Key Considerations for Pharmacists in Primary Care', by clicking here.

Additionally, if you would like to view our latest free resource on HRT, or the HRT-related courses we have available, please click here.