Joshua R. Gonzalez MD | Sexual Health + Urology
Menopause is a natural transition in a woman’s life, but for many, the symptoms can significantly impact their quality of life. From hot flashes and night sweats to mood changes and sexual health concerns, the hormonal shifts of menopause can be challenging. One of the most discussed—and often misunderstood—treatments for menopause is Hormone Replacement Therapy (HRT). At Joshua R. Gonzalez MD | Sexual Health + Urology, we are committed to providing clear, evidence-based information to empower women in making informed decisions about their health.
In this blog, we’ll explore menopause, the role of hormones, and separate fact from fiction when it comes to HRT.
Understanding Menopause
What is Menopause?
Menopause marks the end of a woman’s reproductive years, officially diagnosed after 12 consecutive months without a menstrual period. It typically occurs between ages 45 and 55 but can happen earlier or later.
Symptoms of Menopause
- Hot flashes and night sweats
- Vaginal dryness and discomfort during intercourse
- Mood swings, irritability, and anxiety
- Sleep disturbances
- Decreased libido
- Weight gain and metabolic changes
- Cognitive changes (“brain fog”)
These symptoms are primarily driven by declining levels of estrogen and progesterone.
What Is Hormone Replacement Therapy (HRT)?
Hormone Replacement Therapy (HRT) involves supplementing the body with hormones—typically estrogen, progesterone, and even testosterone—to restore hormonal balance and alleviate menopause symptoms. HRT can be administered through pills, patches, injections gels, creams, or vaginal rings.
There are two main types of HRT:
- Estrogen-only HRT – For women who have had a hysterectomy.
- Combined HRT (estrogen + progesterone) – For women who still have their uterus, to protect against endometrial cancer.
Benefits of HRT
HRT is one of the most effective treatments for menopause-related symptoms. Some of the proven benefits include:
- Relief from hot flashes and night sweats
- Improved vaginal health – Alleviates dryness, itching, and discomfort during intimacy.
- Better sleep quality – By managing night sweats and mood swings.
- Mood stabilization and enhanced mental clarity
- Bone health protection – Reduces the risk of osteoporosis and fractures.
- Improved sexual health and libido – Restoring hormonal balance can reignite sexual desire and comfort.
The Truth About HRT Risks
While HRT offers many benefits, concerns about safety—especially regarding cancer and cardiovascular risks—have led to confusion. Much of the fear stems from the early 2000s Women’s Health Initiative (WHI) study, which found increased risks of breast cancer, stroke, and heart disease in some women using HRT. However, later analyses and more recent studies have clarified that:
- For healthy women under age 60 or within 10 years of menopause onset, the benefits of HRT typically outweigh the risks.
- The type of HRT, route of administration, and individual health history all influence risk levels.
- Topical or transdermal HRT (patches, gels) may carry fewer cardiovascular risks than oral forms.
- Progesterone use with estrogen is necessary for women with a uterus to prevent endometrial hyperplasia.
At Joshua R. Gonzalez MD | Sexual Health + Urology, we take a personalized approach, assessing your overall health, goals, and concerns before recommending HRT or alternative therapies.
Q&A: Hormone Replacement Therapy and Menopause
Q: Is HRT safe for everyone?
A: Not everyone is a candidate for HRT. Women with certain conditions, like a history of breast cancer, blood clots, or liver disease, may need to explore non-hormonal alternatives. A thorough evaluation with a specialist is key.
Q: How long can I stay on HRT?
A: There’s no universal time limit. Many women use HRT for 5–10 years, but it depends on symptom control and risk profile. Regular check-ups help determine when and if it’s time to reduce or stop therapy.
Q: Can HRT help with sexual health issues during menopause?
A: Absolutely. Estrogen therapy can significantly improve vaginal lubrication and elasticity, reducing pain during intercourse. It can also support libido, especially when combined with testosterone therapy in select cases.
Q: Are there natural alternatives to HRT?
A: Yes, options like lifestyle changes, herbal supplements, and non-hormonal medications (e.g., SSRIs for hot flashes) can provide relief. However, their efficacy varies, and they may not offer the same benefits as HRT for bone or vaginal health.
Q: Does HRT increase breast cancer risk?
A: The risk is complex. Combined HRT may slightly increase breast cancer risk with long-term use, but estrogen-only therapy does not show the same effect and may even reduce risk in some women. Discussing your personal and family history is vital to making informed choices.
Personalized Menopause Care in Los Angeles
Dr. Joshua R. Gonzalez offers comprehensive care for women navigating menopause, with a focus on sexual health, hormonal balance, and overall well-being. We understand the emotional and physical challenges of this transition and are here to guide you through evidence-based treatment options, including HRT when appropriate.
Whether you are struggling with night sweats, low libido, or vaginal discomfort, our goal is to help you reclaim your vitality and feel confident in your body again.
Contact Us
Joshua R. Gonzalez MD | Sexual Health + Urology
📍5757 Wilshire Blvd, Suite 475
Los Angeles, CA 90036
📞 Phone: (323) 607-2895
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Take the first step toward balanced health. Schedule your consultation today to explore how Hormone Replacement Therapy can help you feel like yourself again.