The benefits of hormone replacement therapy (HRT) usually outweigh the risks. Recent evidence says that the risks of serious side effects from HRT are very low.
The benefits and risks of taking HRT depend on your age, your menopause symptoms and any risk factors you have.
The benefits are likely to outweigh the risks if you:
- are under age 60
- have menopause symptoms
- are not at high risk of breast cancer or blood clots
- start HRT within 10 years of becoming menopausal
Talk to your GP. They will help you decide.
When to take HRT and how long to take it for
Benefits of HRT
HRT can have the following benefits.
Relieving menopause symptoms
The main benefit of HRT is providing relief for perimenopause and menopause symptoms, such as:
- hot flushes
- night sweats
- sleep problems caused by menopause
- anxiety and low mood caused by menopause
- vaginal dryness
You should find that your symptoms improve after a few days or weeks of taking HRT.
Preventing osteoporosis
Osteoporosis is thinning of the bones, which makes you more likely to have a fracture. It's common after menopause because your level of oestrogen falls. Oestrogen is needed for healthy bones.
HRT helps to prevent osteoporosis by increasing your level of oestrogen.
It's particularly important to take HRT to help prevent osteoporosis if your periods stop before age 45 (early menopause).
Maintaining muscle strength
It's common to lose muscle strength as you reach menopause. HRT can improve this and help your muscles stay strong. It's also important to exercise.
Risks of HRT
The risks of any serious side effects are usually very low.
They depend on:
- the type of HRT you take
- how long you take it
- your own health risks
Non-urgent advice: Talk to your GP if:
- you're thinking about starting HRT or you're already taking it, and you're worried about any risks
Breast cancer
HRT can slightly increase the risk of breast cancer. If you've had breast cancer you'll usually be advised not to take HRT.
The increased risk is low. There are around 5 extra cases of breast cancer in every 1,000 women who take combined HRT for 5 years.
The risk increases the longer you take it, and the older you are. It falls again after you stop taking it.
There is little or no increase in the risk of breast cancer from oestrogen-only HRT. You can take this if you've had a hysterectomy to remove your womb.
You can reduce the risk of breast cancer by not taking HRT for longer than you need it to control your symptoms.
There are also lifestyle changes that can reduce the risk of breast cancer.
It's important to go to all your breast screening appointments if you're taking HRT.
Womb cancer
You'll usually be prescribed oestrogen and progestogen.
This is because taking oestrogen on its own can increase your risk of womb cancer. Progestogen helps protect your womb.
Blood clots
HRT tablets can increase the risk of blood clots. But the risk is very low.
HRT patches, sprays and gels do not increase the risk of blood clots. This is because oestrogen is safer when it's absorbed into your body through your skin.
If you're at risk of blood clots you'll usually be advised to use HRT patches, spray or gel rather than tablets.
Stroke
HRT tablets (but not patches, gel or spray) slightly increase the risk of stroke. But the risk is very low, particularly if you're under age 60.
Research into HRT and other conditions
Research has shown that taking HRT has little or no effect on the risk of getting coronary heart disease.
More research is being done to find out how taking HRT affects some other conditions, such as dementia and diabetes. Any increased risk or benefit is likely to be small.
It's not known whether HRT reduces the risk of dementia.
HRT does not increase the risk of developing type 2 diabetes. Some recent studies have suggested that it may even slightly reduce the risk.
Benefits and risks of vaginal oestrogen
Vaginal oestrogen helps with vaginal dryness. It does not increase the risk of breast cancer, blood clots or other conditions.
The dose is low and very little of the medicine gets into the rest of your body. This means it's safe to use it for a long time.