Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) is a medicine-based treatment used to relieve symptoms of menopause and perimenopause.

There are different types of HRT. Your GP will help you decide if HRT is right for you and give advice on the type that would suit you best.

HRT medicine comes as tablets, skin patches, gels, sprays, vaginal creams or pessaries.

Uses of HRT

HRT balances and replaces the hormones that your body no longer produces in the same way because of perimenopause and menopause.

It helps relieve most menopausal symptoms, such as:

• hot flushes
• night sweats
• mood swings
• vaginal dryness
• reduced sex drive

Many of these symptoms pass in a few years, but they can be unpleasant.

Taking HRT can relieve symptoms for many women.

HRT can also help reduce the risk of:

• osteoporosis (weakening of the bones) - this is more common after menopause
• certain types of heart diseases - if you start it before you are 60 years of age

Starting HRT

Talk to your GP if you want to start HRT. They will tell you if HRT is suitable for you and discuss the different types of HRT available.

You can usually begin HRT as soon as you start having menopausal symptoms. Depending on your age, you do not usually need to have any tests first.

Some types of HRT can slightly increase your risk of certain serious problems, such as blood clots and breast cancer. But the benefits outweigh the risks for most women.

Learn about the risks of HRT before starting treatment.

HRT dose

You'll usually start on a low dose.

It may take a few weeks to feel that the treatment is working. You might also have some side effects.

Your GP will normally advise you to stay on the treatment for at least 3 months.

After 3 months, if you feel that the treatment is not working, your GP may change your dose or the type of HRT you're taking.

Learn about the different types of HRT and ways of taking them.

Weight gain and HRT

There is no evidence that shows HRT causes weight gain.

Check if you can have HRT

Most women can have HRT if they have symptoms related to menopause.

But your GP may recommend alternatives to HRT if you:

• have had breast cancer, ovarian cancer or womb cancer
• have had blood clots
• have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
• have liver disease
• are pregnant

Learn about the risks of HRT before starting treatment.

Pregnancy and HRT

It's still possible to get pregnant while on HRT.

If you do not want to get pregnant, you should use contraception until 2 years after your last period if you're under 50 or for 1 year after the age of 50.

Stopping HRT

Talk to your GP about how long you should have HRT.

Most women stop taking it when their menopausal symptoms pass. This is usually after a few years.

Gradually decreasing your HRT dose is usually recommended. This is less likely to cause your symptoms to come back.

Talk to your GP if you have:

• symptoms that continue for several months after you stop HRT
• severe symptoms

You may need to start HRT again.

Side effects of HRT

HRT can cause side effects. But these usually pass within 3 months.

Talk to your GP if you have severe side effects or if your side effects continue for longer than 3 months.

Your GP may recommend:

• switching to a different way of taking progestogen or oestrogen
• changing the specific medicine you're taking
• lowering your dose

Side effects of oestrogen

The main side effects of taking oestrogen include:

• bloating
• breast tenderness or swelling
• swelling in other parts of the body
• feeling sick
• leg cramps
• headaches
• indigestion
• vaginal bleeding

These side effects often pass in a few weeks.

You can relieve some of these side effects by:

• taking your oestrogen dose with food - this may help to reduce feelings of sickness and indigestion
• eating a low-fat, high-carbohydrate diet - this may reduce breast tenderness
• exercising regularly and stretching - this may help reduce leg cramps

Side effects of progestogen

The main side effects of taking progestogen include:

• breast tenderness
• swelling
• headaches or migraines
• mood swings
• depression
• acne
• tummy (abdominal) pain
• back pain
• vaginal bleeding

These usually pass in a few weeks.