Hormone Replacement Therapy is a treatment that helps alleviate menopause symptoms such as hot flushes and vaginal dryness. It aims to replace female hormones (oestrogen and progesterone) which decline during the menopausal transition. HRT can also protect against long-term health risks such as osteoporosis and dementia.
Women can take HRT either as tablets, a cream or gel or by using a transdermal patch. It is important to discuss the pros and cons of each with your GP.
Research shows that HRT can help with the early stages of perimenopause, by helping your body adjust to the changing hormones and prevent symptoms. It also has protective effects on the brain, and can cut a woman’s risk of Alzheimer’s disease by 79% if started before menopause.
The type of HRT you take will depend on the severity and duration of your symptoms, your family history and your age. The most common type of HRT is a combination of both oestrogen and progestogen, but there are many other types including oestrogen only. It is important to discuss this with your GP and explore non-hormonal options such as diet, exercise and weight management.
You can buy oestrogen and progestogen over-the-counter in the UK, and the type of hormones your GP prescribes will depend on whether you have a womb or not, as well as the severity of your symptoms. For example, a gynecologist may recommend oestrogen-only HRT for women who have had their womb removed during a hysterectomy.
During the perimenopause, it is important to monitor your risk for cardiovascular disease, cancer, and diabetes. You should also keep in mind that HRT can cause a slight increase in the size of the breasts, which can lead to an increased risk of breast cancer. This is why it is important to get regular screening mammograms while taking HRT.
In addition to oestrogen and progestogen, you can also buy estrogen-only HRT that does not contain progestin, as well as a variety of other medications. It is important to discuss the risks and benefits of each with your GP, as you may need to try several different types before you find one that suits you.
HRT is not recommended for premenopausal women, but may be prescribed if you’ve had your ovaries surgically removed before age 45 (premature or early menopause) or lost the normal function of your ovaries by age 40 (primary ovarian insufficiency). It can also be used to restore sex drive in a few women who have low libido.
The choice to use HRT can be a difficult one for many women. The decision should be made during a special appointment with your gynecologist, who will consider your age, medical history and the severity of your menopausal symptoms. This will allow your GP to talk with you about the pros and cons of each type and form of hormone replacement therapy, and other alternative options to improve your quality of life. Talking openly about these risks, and the symptoms that are bothering you, will help you make the right decision for you.