Understanding Hormone Replacement Therapy


Hormone replacement therapy (HRT) is well-known as the main treatment method for managing menopausal symptoms. It helps to regulate your hormones, which will ease many of the symptoms associated with menopause. 

Over the years, there’s been lots of debate on the pros and cons of HRT – with many women hesitant to take it. Here we outline the key details. 

Of course, bear in mind that this is not medical advice – before starting any medication you should have a detailed consultation with your GP who will assess your suitability for taking HRT and share all the information you need to help you make an informed decision. 

Quick Summary

  • Hormone Replacement Therapy (HRT) is used to manage menopausal symptoms by regulating hormones
  • HRT alleviates symptoms such as hot flushes, mood swings, vaginal dryness, and night sweats
  • It can be administered as tablets, implants, skin patches, gels, or sprays
  • Benefits include symptom relief and reduced risks of osteoporosis and heart disease
  • Possible side effects are bloating, breast tenderness, headaches, and mood swings
  • Risks include a small increase in breast cancer and blood clots, mainly with HRT tablets
  • Consult a GP to discuss suitability and side effects

What is Menopause?

The menopause is something that all women will experience. It occurs when women’s periods stop due to lower hormone levels; the ovaries will stop producing as much of the oestrogen hormone and no longer release an egg each month. Perimenopause is the time leading up to this event; women will often experience irregular periods and other symptoms associated with a decline in their hormones. These can include: 

  • Brain fog
  • Anxiety
  • Mood swings
  • Hot flushes
  • Irregular periods
  • Difficulty sleeping
  • Headaches and migraines that are worse than usual
  • Weight gain
  • Dry skin 
  • Reduced sex drive
  • Muscle aches and joint pains 
  • Vaginal dryness and pain
  • Discomfort during sex
  • Urinary tract infections (UTIs)

Many women find these symptoms have a big impact on their overall quality of life, which is why they seek treatment with HRT. 

What is HRT?

HRT is a treatment to help relieve the symptoms of perimenopause/menopause. It can be prescribed by your GP after a consultation. 

HRT replaces your body’s levels of oestrogen and/or progesterone to ease symptoms. It can also help reduce the risk of osteoporosis and heart disease.

Oestrogen can come as:  

  • Tablets
  • Implants
  • Skin patches
  • Gel or spray  

 Progesterone is taken to protect the womb lining from the effects of oestrogen. It can come as:  

  • Patches (combined with oestrogen)  
  • Coil
  • Tablets 

 Women can also take testosterone to improve their sex drive.  

What Are the Benefits of Taking HRT?

Taking HRT can greatly ease symptoms associated with menopause. You should see an improvement in: 

  • Hot flushes
  • Mood swings
  • Vaginal dryness
  • Sex drive
  • Irregular periods
  • Brain fog
  • Anxiety
  • Night sweats

HRT can also help reduce thinning of bones, which can lead to osteoporosis. 

What Are the Benefits of Taking HRT?

What Are the Side Effects of Taking HRT?

As with most medicines, there are side effects associated with taking HRT. 

Oestrogen

If you take oestrogen, you may experience: 

  • Bloating
  • Breast tenderness or swelling
  • Swelling in other parts of the body
  • Feeling sick
  • Leg cramps
  • Headaches
  • Indigestion
  • Vaginal bleeding

The NHS highlights that these often pass after a few weeks, but you can contact your GP to switch how you take your oestrogen which can help. 

Progestogen

Progestogen

Taking progestogen may lead to: 

  • Breast tenderness
  • Swelling in other parts of the body
  • Headaches or migraines
  • Mood swings
  • Depression
  • Acne
  • Abdominal pain
  • Back pain
  • Vaginal bleeding

Again, you can speak to your GP about switching to a different dose or form if side effects persist after a few weeks. 

What Should You Do if HRT Side Effects Don’t Ease?

If you’re suffering from severe side effects or they last longer than three months, then it is advisable to speak to our GP for their support

What Are the Risks of Taking HRT?

The NHS outlines that there are risks associated with taking HRT, but clinical research has found them to be very minimal. It says the benefits usually outweigh the risks. 

Breast Cancer

Combined HRT can be associated with a small increase in the risk of breast cancer, while there is little or no change in the risk if you take oestrogen-only HRT, according to the NHS. 

The increased risk relates to how long you take HRT, and it falls after you stop taking it. 

Ensure you attend all of your breast cancer screenings if you’re taking HRT. 

Blood Clots

The NHS says that there is a small risk of blood clots if you take HRT tablets, while there’s no risk if you use HRT patches or gels. 

Heart Disease and Strokes

There’s no evidence to suggest that taking HRT significantly increases your risk of heart disease and strokes before the age of 60. That said, the NHS notes that HRT tablets are associated with a small increase in the risk of stroke but this is very small. 

Are There Alternatives to Taking HRT?

While HRT is the main clinical treatment available to help regulate your hormones and calm menopausal symptoms, there are alternative therapies you can try.

As always, if you have any questions you can use our Menopause Q&A where you can ask for more advice.

We have lots of Menopause FAQs, Menopause videos, Menopause reviews, and Menopause before and after images for you to do more research.

If you want to look for your nearest verified Menopause clinic, your local menopause clinics are listed below.