Hormone replacement therapy, commonly referred to as HRT, is a versatile medical treatment used to address various conditions caused by hormonal imbalances or deficiencies. While HRT can be utilized for anyone experiencing clinical hormone shifts, it is most commonly prescribed to women during the transition into menopause to manage the significant decline in estrogen and progesterone.

For many, this transition feels like losing control over their own bodies. As a physician and menopause specialist specializing in midlife health, Dr. Deshanie Govender frequently consults with patients who feel overwhelmed by conflicting information regarding the safety and efficacy of these treatments. This guide provides evidence-based clarity to help patients move from uncertainty to informed, confident decision-making.

What is Hormone Replacement Therapy (HRT)?

Hormone Replacement Therapy is an FDA-approved medical intervention designed to replenish the hormones, specifically estrogen and progesterone, that the ovaries stop producing during perimenopause and menopause.

Unlike unregulated “wellness” supplements, clinical HRT uses standardized, bioidentical hormones that are chemically identical to the hormones your body naturally produces, allowing for precise dosing and predictable safety outcomes.

The Role of Estrogen and Progesterone

• Estrogen: Regulates body temperature, maintains bone density, protects the cardiovascular system, and supports vaginal tissue elasticity.
• Progesterone: Primarily protects the uterine lining (endometrium) from thickening when estrogen is administered. It also has a natural calming effect that can improve sleep quality.

How Physicians Use Hormone Replacement Therapy in Menopause Care

Menopause typically occurs between the ages 45 and 55, average around 52 in the United States but the physiological impact can begin years earlier during perimenopause. The ovaries gradually produce less estrogen and progesterone, leading to symptoms that range from hot flashes and night sweats to “brain fog” and joint pain.

From a clinical perspective, the severity and pattern of these symptoms are just as important as their presence. Dr. Govender emphasizes that HRT is not a “one-size-fits-all” solution. Instead, treatment is individualized based on a patient’s symptoms, age, time since menopause, and personal health goals. Whether delivered via oral tablets, transdermal patches, or topical gels, the objective is to intervene before symptoms significantly disrupt bone density, cardiovascular health, or overall quality of life. A menopause specialist can help guide patients through this transition and determine if hormone replacement therapy is appropriate.

Key Benefits of Hormone Replacement Therapy

While most patients seek HRT for symptom relief, the clinical benefits extend to long-term disease prevention:

1. Vasomotor Relief: Effectively eliminates hot flashes and night sweats by stabilizing the body’s thermoregulatory zone.
2. Restorative Sleep: By reducing nighttime temperature fluctuations, HRT helps restore the deep sleep cycles necessary for cognitive function and mood regulation with good sleep hygiene practices.
3. Skeletal Preservation: Estrogen is vital for bone remodeling. HRT serves as a primary defense against bone loss, helping to prevent osteopenia and osteoporosis.
4. Cognitive & Mood Support: Stabilization of hormone levels can mitigate “brain fog” and the specific type of anxiety often triggered by fluctuating estrogen receptors in the brain.
5. Genitourinary Health (GSM): HRT restores vaginal tissue integrity, addressing dryness and discomfort while supporting overall urogenital health and intimacy.

Ideal Candidates for HRT

Eligibility for hormone therapy is determined through a comprehensive clinical evaluation. We look at your medical history, the severity of your symptoms, and your long-term health goals.

Ideal Candidates Often Include:

• Women experiencing moderate to severe menopausal symptoms.
• Women with Premature Ovarian Insufficiency (POI) or early menopause.
• Those seeking to prevent rapid bone loss due to estrogen deficiency.
• Healthy individuals within the 10-year window of their last period.

Contraindications to Consider:

HRT may not be suitable for women with a history of certain hormone-sensitive cancers (such as breast or endometrial cancer), active liver disease, history of blood clots, history of heart attack or stroke or undiagnosed vaginal bleeding. During your consultation, we evaluate alternative non-hormonal treatments if HRT is not the right fit for you.

Types of FDA-Approved Hormone Replacement Therapy

There are multiple FDA-approved HRT options available, allowing treatment to be tailored to each patient’s health needs and lifestyle. Specialists utilize several delivery methods, including transdermal (patches or gels), oral, and vaginal, to ensure the safest clinical outcome.

• Estrogen-Only Therapy: Typically prescribed for women who have had a hysterectomy and do not need progesterone for uterine protection.
• Combined Estrogen and Progesterone Therapy: Recommended for women with a uterus to reduce the risk of endometrial complications.
• Systemic Therapy: Delivered via oral tablets, patches, or gels to manage whole-body symptoms such as hot flashes, night sweats, and bone loss.
• Local Vaginal Therapy: Targeted creams, tablets, or rings that treat vaginal dryness and discomfort with minimal systemic absorption.

What to Expect During Hormone Replacement Therapy and Maintaining Results

The HRT journey begins with a comprehensive consultation to review medical history and identify specific clinical goals. Rather than relying solely on blood tests, which can be inconsistent during perimenopause, a specialist evaluates the pattern of symptoms to determine the most effective starting dose and delivery method.

Once treatment begins, many patients notice an improvement in sleep and vasomotor symptoms within the first two weeks, though it typically takes 90 days for the body to reach a stable physiological state. Success is maintained through regular follow-up appointments to monitor for side effects and adjust dosages as the body’s needs evolve. For optimal long-term results, therapy should be paired with a well-balanced lifestyle, including weight-bearing exercise for bone health, adequate vitamin D intake, and routine screenings like mammograms or bone density testing.

Potential Risks and Considerations

While hormone replacement therapy is considered safe for many women, understanding potential risks is essential. Key risks include:

• Blood Clot Risk: May slightly increase the risk of blood clots, particularly in women with pre-existing risk factors.
• Breast Health Considerations: Long-term use of combined therapy may slightly increase the risk of breast cancer, depending on duration and personal history.
• Cardiovascular Factors: Age, timing of therapy initiation, and heart health can influence risk.
• Need for Ongoing Monitoring: Regular check-ins allow your physician to assess symptom control, monitor for side effects, and make any necessary adjustments.
• Other Possible Side Effects: Some women may experience mild symptoms such as breast tenderness, bloating, or spotting, especially during the first few months of therapy.

HRT at Florida Medical Clinic Orlando Health

At Florida Medical Clinic Orlando Health, our dedicated team uses FDA-approved conventional therapies and follows evidence-based protocols. We focus on understanding your symptoms, explaining treatment options, and addressing any questions or concerns. If you’re searching for HRT near you, contact our experienced physicians and find a location near you, such as Land O’ Lakes, Zephyrhills, or our other Florida Medical Clinic Orlando Health locations. We specialize in helping women manage menopausal symptoms safely and effectively. Start feeling like yourself again with personalized HRT care.

Menopause is not a condition to “push through,” and hormone-related symptoms should never be dismissed as something women must simply endure. With the right guidance and evidence-based care, hormone replacement therapy can be a powerful tool for improving quality of life during this transition.

About Deshanie Govender, MD, MSCP

Dr. Deshanie Govender is a board certified physician specializing in menopause and midlife women’s health. As a Menopause Society Certified Practitioner (MSCP), she belongs to a select group of clinicians nationwide recognized for expertise in evidence-based hormone therapy.

Dr. Govender earned her medical degree from St. George’s University School of Medicine and a Bachelor of Arts in Psychology magna cum laude from the University of South Florida. Her patient-centered approach integrates medical education with lifestyle guidance and individualized treatment. Beyond her clinical practice, she is a passionate advocate for community health and the founder of The Period Project Corporation, a nonprofit dedicated to addressing period poverty.

Schedule a consultation with Dr. Govender at Florida Medical Clinic Orlando Health by calling (813) 875-8453.