Types of HRT - Hormone replacement therapy (HRT)

There are different types of HRT, treatment plans and ways of taking HRT. Your GP will help find the right treatment for you.

HRT hormones

HRT replaces the hormones that your body no longer produces because of the menopause.

Oestrogen and progestogen

The 2 main hormones used in HRT are oestrogen and progestogen.

Types of oestrogen include estradiol, estrone and estriol.

Types of progestogen include dydrogesterone, medroxyprogesterone, norethisterone and levonorgestrel.

Most women take a combination of oestrogen and progestogen. But women who do not have a womb can take oestrogen on its own.

Women who have a womb must take both oestrogen and progestogen. This is to reduce your risk of womb cancer.

HRT treatment plans

The 2 types of HRT treatment plans are:

  • cyclical (or sequential) HRT
  • continuous HRT

The plan you use depends on the stage of menopause you are in.

Cyclical HRT

Cyclical HRT is also known as sequential HRT.

It is often recommended for women taking combined HRT who have menopausal symptoms but still have their periods.

There are 2 types of cyclical HRT:

  • monthly HRT
  • 3-monthly HRT

Monthly HRT

You take oestrogen and progestogen every day for the last 14 days of your menstrual cycle.

Monthly HRT is usually for women who have regular periods.

Talk to your GP about HRT options if you have irregular periods.

Continuous combined HRT

Continuous HRT involves taking oestrogen and progestogen every day without a break.

Oestrogen-only HRT is also usually taken continuously.

Continuous combined HRT is usually for women who are postmenopausal. This is when you have not had a period for a year.

How and when to take HRT

HRT is available in different ways. Talk to your GP about the best option for you.

Taking your oestrogen dose with food may help to reduce side effects, such as sickness and indigestion.

Tablets

Oestrogen-only and combined oestrogen and progestogen HRT tablets are available. They're usually taken once a day.

The risks of HRT, such as blood clots, is higher with tablets than with other forms of HRT.

Skin patches

You stick skin patches on your skin and replace them every few days. Oestrogen-only and combined oestrogen and progestogen HRT patches are available.

Using patches can help avoid some side effects of HRT, such as indigestion. HRT patches do not increase your risk of blood clots.

Oestrogen gel

Oestrogen gel is applied to the skin once a day and absorbed.

Taking oestrogen gel also avoids the increased risk of blood clots that comes with HRT tablets.

If you still have your womb, you will need to take progestogen also. You can take progestogen as part of combined HRT.

Another option is the intrauterine system (IUS). An IUS releases a progestogen hormone into the womb. It can stay in place for a few years and also acts as a contraceptive.

Vaginal oestrogen

Oestrogen is also available in the form of a cream, pessary or ring that is placed inside your vagina.

This can help relieve vaginal dryness, but it will not help with other symptoms such as hot flushes.

It does not carry the usual risks of HRT. You can use vaginal oestrogen without taking progestogen even if you still have a womb.

Testosterone

Testosterone is available as a gel that you rub in your skin.

It is usually only recommended for women whose low sex drive (libido) does not improve after using HRT.

It is used alongside your current HRT type.

Your GP can give you more information on testosterone products.


Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 7 July 2021
Next review due: 7 July 2024