Hormone Replacement Therapy (HRT) is an approach to subdue and tackle some health-related issues like menopause. This therapy uses a combination of hormones to manage symptoms that come with menopause. The Cost of Hormone Replacement Therapy in Canada depends on some factors; province, health facility, medication brand, etc. HRT is not suitable or recommended for everyone, a doctor or a healthcare provider should be duly contacted for proper examination to determine the best approach.
Hormone Replacement Therapy – An Overview
Hormone Replacement Therapy is a hormonal medication aimed at relieving the symptoms most women experience when going through menopause. Some of these symptoms include hot flashes, night sweats, vaginal dryness, tiredness, decreased sex drive, irritabilities, etc.
HRT is a medication used to replace a woman’s hormones during menopause. Menopause is a stage in every woman’s life when her menstrual period stops and the sex hormone levels decline. HRT is aimed at relieving menopausal symptoms and prevent complications that may arise like Osteoporosis (thinning of the bones) and bowel cancer.
HRT works by replacing the hormone known as estrogen that the female body stops releasing. This hormone stops during menopause or in a case where the ovaries have been removed.
Types of HRT
There are currently several ways of delivering HRT, and the type you’re required to take depends on the stage of your menopause. The different types of HRT have distinct combinations and several hormones. They include:
- Estrogen only
This is recommended for women who have had their womb removed (hysterectomy) or are using the intrauterine system (IUS) like Mirena. This type of HRT does not contain progestogen as it is not necessary.
- Combined HRT
This is the combination of estrogen and progestogen. It is recommended for women who still have their uterus. It can be administered in two ways, which includes:
- Continuous Combined HRT
Both estrogen and progesterone are taken daily – one per day for 28 days. With this approach, there is no withdrawal bleeds.
- Sequential HRT
This is a simultaneous approach that involves the use of estrogen-only for the first 14 days then both estrogen and progesterone for the second 14 days. Note that in most cases, this usually results in monthly withdrawal bleeds.
- Cyclical/Sequential HRT
This is an option recommended for women you experience symptoms before menopause. The dosage is usually prescribed to align with the menstrual cycle.
- Local Oestrogen
This includes vaginal tablets, creams, or rings. They are used to subdue/treat urogenital symptoms like vaginal dryness and irritation.
Cost of Hormone Replacement Therapy in Canada
Since HRT is only available on prescription, it is important to state that the cost is usually charged at the current rate of the prescription. Also, HRT prescription sometimes involves two medicines, so you might need to cover the cost for these two prescriptions if your provincial healthcare doesn’t cover it.
In some provinces in Canada, like Saskatchewan, HRT is covered by insurance. But for those not insured, the average monthly cost of hormone replacement therapy is between CA$10 to CA$85, the actual price is dependent on the drugs prescribed.
HRT is covered by most health insurance plans in Canada while others do not because they believe HRT is a normal part of aging. If you are insured, you only get to pay CA$5 – CA$30 monthly. Note that there are some other charges you might want to budget for like:
- A visit to the doctors – CA$75 – CA$200 without insurance
- Blood test – CA$1,000
- Periodic check-ups
Side Effects of HRT
Most women experience side effects in the first few months of HRT. Most of these symptoms are normal and do not pose any threat to life. But if these symptoms persist after three months, always contact your doctor.
Although HRT can help manage hot flashes and other menopause symptoms, some side effects come with HRT. Some of them include:
- Depression
- Nausea
- Mood Changes
- Abdominal or Back Pain
- Leg Cramps
- Swelling in The Breasts or Other Parts of The Body
- Vaginal Bleeding
- Acne
- Bloating
- Indigestion
- Breast Tenderness
- Headaches
- Migraine
Most of these side effects usually go after a few weeks. Always speak to your doctor if you have any concerns with any of the side effects.
Noteworthy – women who take HRT for over a year are at a higher risk of breast cancer than women who never used HRT. This risk is linked to all types of HRT except vaginal estrogen.
Who Should Consider HRT?
As we mentioned earlier, HRT is not suitable for everyone. You can only consider hormone replacement therapy if your menopausal symptoms are severe and posing a threat to your life. Your doctor might prescribe HRT for you if:
- You have several menopausal symptoms like insomnia, painful sexual intercourse, night sweats, headaches, etc.
- There’s a history of osteoporosis or colon cancer in your family
- You hit menopause before age 40
- Other approached has failed to relieve your menopausal symptoms
- Your ovaries were removed before age 45
- Due to chemotherapy or radiation, you hit menopause before age 45
Who Should Not Consider HRT?
HRT is not suitable for people with the following conditions/history:
- Heart disease
- Breast Cancer
- Hypertension
- Gallbladder disease
- High blood pressure
- Stroke
- High levels of triglycerides in the blood
- Blood clots or thrombosis
- Pregnancy
- Mil menopausal symptoms
- Not at risk of Osteoporosis
Administering HRT
The right dosage required of your symptom will be prescribed by your doctor. Note that in some cases, knowing the right dosage might take some trial and error. Some of the ways of administering HRT to a patient include:
- Skin patches
Skin patches for HRT come in estrogen packs and a combination of estrogen and progestogen packs. They are to be applied once or twice weekly to any area beneath the waist. Skin patches are effective in relieving short and long-term menopausal symptoms.
- Creams/gels
HRT gel is clear and non-greasy, so an allergic reaction is less likely to happen. HRT gels are available for estrogen-only prescription. It is to be applied once daily to a clean/dry area of the body. Recommendable, the upper arm, shoulder, or inner thigh. It is to be rubbed in as it takes a few minutes to dry. In a case where the womb is still intact, then HRT gel should be used alongside progesterone tablets or Intra-Uterine System (IUS).
- Tablets
There are several HRT tablets available to relieve menopausal symptoms. They are a combination of estrogen and progesterone or just estrogen. They are to be taken once daily.
- Vaginal Estrogen
These are available in creams, tablets, rings, or pessaries. They contain a small amount of estrogen which works specifically for symptoms where they are applied. They relieve urinary symptoms and vaginal dryness.
In a case where a patient no longer requires HRT, the doctor will prescribe how to gradually stop medications. Generally, it takes a few weeks for the impact of HRT to start kicking in, and about three months to feel the full effects. Body systems differ, so it might take your body some time to get used to the therapy.
In the process of your body getting used to HRT, you might experience some side effects like breast tenderness, leg cramps, nausea, etc. Nothing to worry about though, as these side effect usually disappears with six-eight weeks. But if it persists beyond the stated timeline, a change in the type or dosage of HRT is advisable. Contact your doctor to get relevant information on your symptoms.
When to Stop Hormone Replacement Therapy
The duration of HRT varies per patient and the recommendations made by your doctor. There are no limits on how long you can take HRT, though most women stop immediately after their menopausal symptoms cease.
These symptoms usually take a few years to pass. Gradually reducing your HRT dosage is advisable as it is likely to bring back your symptoms in the short term. Always speak with your doctor if you have any worries or questions.
