Hormone Replacement Therapy (HRT) is a treatment used to relieve symptoms of menopause in women who need it.

It replaces the female hormones that are at a lower level as you experience menopause.

Oestrogen and progesterone are female hormones that play important roles in a woman’s body. Falling levels cause a range of physical and emotional symptoms, including hot flashes, mood swings, and vaginal dryness.

The aim of HRT is to restore female hormone levels, which can bring relief to many women.

How to get started on HRT

Speak to your local GP practice if you’re interested in starting HRT.

You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. However, a blood test to measure your hormone levels may be carried out if you’re aged 40 to 45. Blood tests may also be carried out to help diagnose suspected premature menopause if you’re under 40 and have menopausal symptoms.

A doctor can explain the different types of HRT available and help you choose one that’s suitable for you.

Types of HRT

There are two main types of HRT:

  • combined HRT (estrogen and progestogen) – for women who still have their wombs;
  • estrogen-only HRT – for women who have had their wombs removed in a hysterectomy.

There are several ways that estrogen can be taken, including:

  • tablets – which can be taken by mouth;
  • a patch that you stick on your skin;
  • an implant – under local anesthetic;
  • estrogen gel – which is applied to the skin and absorbed;
  • estrogen spray—which is applied to the forearm.

When required to protect the womb lining from being stimulated by estrogen, a progestogen is available as:

  • combined with estrogen in tablets;
  • combined with estrogen in patches;
  • separately as tablets or a progestogen-releasing coil.

Choosing the right HRT for you

It is important to find the correct HRT to help your symptoms.

A low dose of HRT hormones is usually prescribed, to begin with. If you need to, you can increase your dose at a later stage.

Once you’ve started HRT, it’s best to take it for a few months to see if it works well for you. If not, you can try a different type or increase the dose. It’s really important that you talk to your GP if you have any problems with HRT.

Shortage of some HRT products

There are ongoing supply problems with some HRT products. For some products, this is because of irregular supply while for others it’s a longer-term shortage. There are lots of different reasons why medicines can be in short supply. Work is happening with the pharmaceutical manufacturers who make the medicines to help the situation.

If your pharmacy can’t supply the specific HRT product you’ve been prescribed, they may supply an alternative product. This will usually have the same ingredient but may be made by a different manufacturer. Your pharmacy might also reduce the amount they provide you with to help ensure that as many women as possible can get access to their required medication.

Disruptions in the availability of HRT will be worrying if it has been prescribed for you. However, there are always alternative options. If you are concerned about this contact your GP, pharmacist, or specialist doctor to discuss the best treatment options for you.

When HRT is not suitable

HRT may not be suitable, or a specialist opinion may be needed if you:

  • have a history of breast cancer, ovarian cancer, or womb (uterus) cancer;
  • have a history of blood clots, tablet HRT is not recommended but taking HRT through the skin can be considered;
  • have a history of heart disease or stroke;
  • have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT;
  • have liver disease;
  • are pregnant or breastfeeding.

In these circumstances, a different type of medication may be prescribed to help manage your menopausal symptoms.

Understanding the benefits and risks

Recent findings show that although not completely risk-free, HRT remains the most effective solution for helping with symptoms of menopause and is also effective for the prevention of osteoporosis. It may also provide protection against heart disease.

When deciding whether to have hormone replacement therapy (HRT), it is also important to understand the risks.

For any additional concerns be sure to contact our experts.