Hormone replacement therapy (HRT) is a treatment used to help menopause symptoms.
You can get it free on prescription. But you need to have a medical card or a Drugs Payment Scheme card.
How to get a Drugs Payment Scheme card
HRT can help to treat the following menopause symptoms:
- hot flushes
- night sweats
- sleep problems
- anxiety and low mood
- vaginal dryness
Menopause is when your periods stop due to lower hormone levels. It usually affects women between ages 45 and 55 but it can happen earlier.
It affects anyone who has periods.
How HRT works
HRT replaces the hormones oestrogen and progesterone. These fall to low levels as you approach the menopause.
Oestrogen and progesterone are an essential part of:
- period cycles
- ovulation
- pregnancy
They also keep your bones healthy. As you get older, the loss of these hormones can have a big effect on your body.
To replace these hormones, you'll usually take a combination of oestrogen and progestogen. If you've had a hysterectomy to remove your womb you can take oestrogen on its own.
Who can take HRT
You can usually take HRT if you're having menopause symptoms.
But HRT may not be suitable if you:
- have a history of breast cancer, ovarian cancer or womb cancer
- have a history of blood clots - you may need to use patches or gels rather than tablets
- have untreated high blood pressure - your blood pressure will need to be controlled before you can start HRT
- have liver disease
- are pregnant - it's still possible to get pregnant while taking HRT, so it's important to use contraception until 2 years after your last period under age 50, or for 1 year after age 50
If any of these apply to you, your GP may:
- recommend alternatives to HRT
- refer you to a specialist menopause clinic for advice
Non-urgent advice: Contact your GP if:
- you're over age 45 and considering starting HRT for menopause symptoms
- you're under age 45 and think you're having menopause symptoms - this may be early or premature menopause
Questions to ask your GP
Before you see your GP, it's a good idea to be prepared so you get exactly what you need from the appointment.
If your periods have changed in recent months, make a note of it so you can tell your GP. Also tell them about any medicines or herbal remedies you're taking.
Your questions could include:
- how will HRT help me?
- how soon will I feel better?
- what are the benefits and what are the risks?
- is HRT the only treatment I can have for my symptoms?
- how long will I have to take it for?
- how will I know what type will work best for me?
Your GP can answer your questions. They will help you choose the type of HRT that's most suitable for you.
They may do blood tests and a general check up, depending on your age.
After you start taking HRT
You'll usually start with a low dose. This may be increased later. Your symptoms should improve after a few days or weeks.
A GP will usually recommend a review appointment 3 months after you start taking HRT, or if you change your type of HRT. This is to see how well it's working. If everything is OK, you'll usually have 1 review a year.
If your symptoms do not improve or you get side effects, your GP may suggest:
- changing your dose
- changing the type of HRT you're taking
- referring you to a menopause specialist
You'll usually stay on HRT for 2 to 5 years. But it can be longer in some cases.
Types of HRT
There are many types of HRT, including different hormones and different ways to take or use it. For example, tablets, patches or gel.
Finding the right treatment for you can take some time.
A GP can help you choose what type, method and treatment cycle is best for you.
You can get all types of HRT for free on prescription. But you'll need a Drugs Payment Scheme card.
Benefits and risks
The main benefit of HRT is that it can help with most menopause symptoms, such as hot flushes, mood swings and vaginal dryness. It can also help prevent weakening of the bones (osteoporosis).
Side effects of HRT
Like any medicine, HRT can cause side effects, but not everyone gets them. If you do get side effects, they're usually mild and pass within 3 months of starting treatment.
When to take HRT
It may be difficult to know when to start HRT, how long to take it for and when to stop it. You may also want to know if you can take it while using contraception.
Alternatives to HRT
If you're unable to take HRT or decide not to, you may want to consider other ways of controlling your menopause symptoms. These may include lifestyle changes, other medicines or herbal remedies.