Menopausal symptoms are caused by lack of oestrogen. By replacing the oestrogen, you can feel better. There are oestrogen receptors all over our bodies and in our brains, so replacing it can help.
The million-dollar question
Is HRT dangerous?
HRT is not dangerous. The science is now clear that for healthy women under 60, the benefits of HRT outweigh the risks.
What type of HRT do I need?
HRT contains oestrogen. Unless you have had a hysterectomy, you will also need to take progestogen. The progestogen is used to provide protection against cancer of the lining of the womb. Of course, if you have an intrauterine system or ‘coil’ containing progestogen that is in date (less than five years), then this can work as the progestogen part whilst you have oestrogen.
How do I take HRT?
You can take oestrogen as a pill, or use a patch, gel or spray. Patches are transparent, stick anywhere below your waist and are changed twice a week. Gels and sprays are applied to the skin and dry invisibly in a few minutes.
Progestogen comes combined with oestrogen in patches or pills and is the ideal as the fixed dose is easier to use. If you wanted to ‘mix and match’ or make a bespoke HRT, it is possible to take oestrogen with progestogen, for example oestrogen gel and a progestogen tablet.
Will HRT make me bleed?
It depends where you are in your menopause journey.
If you are still having periods, skipping a few, or it’s less than a year or two since your last period, then you’ll probably find that using a ‘cyclical’ HRT helps to make your bleeds more regular. Simply, this means you take oestrogen every day, then for part of the month, you also take progestogen. When you come to the end of the progestogen, you are likely to have a bleed.
“If your periods are well and truly over, then you can use a ‘continuous combined’ HRT.”
This is the best one to be on eventually, as it gives your womb the optimal overall protection, but if you take it too soon, you might have irregular bleeding. However, if you’ve been on cyclical HRT for years, then you might want to ask your doctor/nurse if they think it’s a good time to change to continuous HRT for better protection.
Can I still get pregnant on HRT?
Yes – if you have a womb and ovaries and it’s before your 56th birthday – unless you are using contraception or have been told otherwise by your healthcare professional.
Will I experience side effects?
Some women can experience unwanted side effects when taking HRT for the first time. These can include leg cramps, breast tenderness, nausea, bloating, irritability, and depression. They may not last for long, but it is important to track them in case a change in type or dose of HRT is required.
And so…
That’s HRT in a nutshell. Of course, all women are individual, which means you have your own specific benefits and risks to weigh up. You may be reading this and thinking, “I don’t fit into this neat category.” You may be over 60, or you may have significant health problems that need considering. You may have tried HRT and not got on with it. My advice is, don’t rule anything out; if you think HRT might be beneficial to you, please go and speak to your primary healthcare professional.
Always remember
It is important to consult your healthcare professional before you make decisions about any new treatment. Getting the right HRT is like finding the right pair of shoes – if one doesn’t suit try another, please don’t give up too soon. Most side effects ease off within the first few months. You might like to use the symptom tracker to help you with this.
Keeping a record of what you are feeling and when it happens gives your healthcare professional vital clues as to what to recommend next. It’s good practice to see your doctor or nurse once you have been on HRT for three months and, ideally, you will need a review once a year. Hopefully you’ll soon be feeling like you again and ready to rock your menopause.
This resource has been reviewed and revised by Philomena McFall.
