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Hormone medications

7-minute read

Key facts

  • Hormones are used as medicines in many ways, including as contraception (to prevent pregnancy) and to help manage symptoms of menopause (known as menopausal hormone therapy — MHT).
  • Hormonal contraception and MHT contain oestrogen or progesterone hormones, or both.
  • Hormone medicines are effective, but may also cause side effects.
  • There are alternatives to both hormonal contraception and MHT.
  • Your doctor can help you balance the risks and benefits of taking hormonal medicines in your situation.

What are hormonal contraceptives?

Hormonal contraceptives are birth control methods that use hormones to prevent pregnancy. There are different types — most contain oestrogen or progesterone hormones, or both.

The most common hormonal contraceptives are:

What is menopausal hormone therapy (MHT)?

Menopausal hormone therapy (MHT) is medicine that uses oestrogen and/or progesterone hormones to relieve some menopausal symptoms and improve your quality of life.

MHT can help relieve these menopause symptoms:

MHT may also help prevent osteoporosis.

MHT is also called hormone replacement therapy (HRT).

How do these medicines work?

Hormonal contraceptives and MHT work by adjusting oestrogen and progesterone levels in your body.

Hormonal contraception

Hormonal contraception prevents pregnancy by:

Read more about how the pill works.

MHT

As you go through menopause, changes in hormone levels can cause symptoms.

How MHT helps:

  • Oestrogen — relieves some menopause symptoms and maintains bone density.
  • Progesterone — protects against endometrial cancer (if you haven't had a hysterectomy).

Other MHT options:

Read more about the different types of MHT.

What types of medicines might I be prescribed?

There are different types of hormonal medicines. They come in different doses, types and combinations. There are advantages, disadvantages and side effects to each type.

Different types of hormonal contraception

The different ways you can take hormonal contraceptives include:

Some are short acting. For example:

  • you need to take pills every day
  • vaginal rings need to be changed once a month

Some are long-acting. IUDs and implants can stay for up to 5 years.

Different types of MHT

The different forms of MHT include:

  • gel
  • pills
  • vaginal pessary, tablet, cream or ring

LOOKING FOR A MEDICINE? — To search by brand name or active ingredient, use the Medicines information search feature.

What are the side effects or risks of these medicines?

Hormonal contraceptives and MHT can cause some of these side effects:

If you are taking hormonal contraceptive or MHT with oestrogen, you are at a slightly higher risk of a blood clot, stroke, heart attack, some cancers and high blood pressure.

Read more about MHT and contraception side effects.

Your doctor will prescribe you the lowest dose possible to minimise side effects. Ask your doctor how long you should continue taking hormonal medicines.

When should I see my doctor?

You should see your doctor:

  • to discuss which type of contraception or MHT is best for you
  • within 6 months of starting MHT
  • once a year, to check your risks and if you need to continue MHT
  • if you are experiencing side effects
  • if you are planning a pregnancy
  • if you want to have your IUD or implant removed

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

Are there any alternatives to these medicines?

There are other options if you do not want to take hormonal medicines.

Alternatives to hormonal contraception

Alternative contraception options include:

Some of these types of birth control are not as effective as hormonal contraception.

Alternatives to MHT

Alternatives to manage your menopause symptoms include:

These are effective for some people.

Yoga, exercise, diet, supplements, weight loss and alternative medicines have not been found to reduce hot flushes or night sweats.

There is little evidence to support using vaginal moisturisers, lubricants and vaginal laser to improve vaginal dryness and other vaginal symptoms.

Read more about managing menopausal symptoms without medication.

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Last reviewed: May 2024


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Hormone replacement therapy - myDr.com.au

Hormone replacement therapy (HRT), now more commonly known as menopausal hormone therapy (MHT), can reduce troublesome menopause symptoms.

Read more on myDoctor website

What is Menopausal Hormone Therapy (MHT) and is it Safe? | Fact Sheet | Australasian Menopause Society Hub

Download: What is Menopausal Hormone Therapy (MHT) and is it Safe?  | Fact SheetAlso see associated Infographic MAIN POINTSMHT (also known as Hormone Replacement Therapy or HRT) covers a range of hormonal treatments that can reduce menopausal symptoms.MHT is the most effective way to control menopausal symptoms while also giving other health benefits.MHT is safe to use for most women in their 50s or for the first 10 years after the onset of menopause.The added risk for blood clots, stroke and breast cancer while taking MHT is very small, and similar to that for many other risk factors such as being overweight.Different types of MHT are associated with different risks. Your doctor can work with you to reduce your risk by using different hormonal treatment options. At menopause, a decrease in oestrogen levels can cause symptoms such as hot flushes, vaginal dryness, mood and sleep changes. If your symptoms are bothering you and you would like to know more about MHT, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms.Menopausal Hormone Treatment or MHT (also known as Hormone Replacement Therapy or HRT) is the most effective way of improving menopausal symptoms. MHT can also benefit your health by improving bone density and reducing the risk of fractures. MHT may also reduce the risk of a fracture and heart disease for some women. If you have had hormone-dependent cancer, you should not take hormone therapies. Speak with your doctor about other non-hormonal prescription medications.Types of MHT (HRT)MHT is available as tablets, patches, gels or vaginal treatments. The type of MHT needed and the associated risks varies according to:your agewhether you have had a hysterectomywhether you have other health conditions.Your doctor can tailor the type of hormone treatment best suited to you. If you had an early menopause you should continue treatment at least until the average age of menopause (51 years).Oestrogen plus progestogenIf you still have your uterus (have not had a hysterectomy), then you need a treatment that combines oestrogen and progestogen. Progestogens (including norethisterone, medroxyprogester , one dydrogesterone and micronized progesterone) are added to the treatment to reduce the risk of cancer of the uterus. Safety facts:Does not cause weight gainBlood clots – patches and gels have minimal or no risk. When using tablets the risk doubles, but is still very low (1 extra case per 1,000 women).Heart disease – no increased risk if MHT begins within 10 years of onset of menopause or before the age of 60.Breast cancer - overall 1 in 8 women will develop breast cancer during her lifetime. The added risk of breast cancer with MHT is very small. The risk increases the longer you take MHT and decreases after stopping. Using a different progestogen may reduce the risk.Stroke – no increased risk for women without underlying stroke risk factors who are in their 50s or during the first 10 years of menopause. Women with risk factors can probably safely use a patch or gel form of treatment. Oestrogen aloneOestrogen alone is suitable for women who have had a hysterectomy.Safety facts:Blood clots – patches and gels have minimal or no risk. When using tablets the risk doubles, but is still very low (1 extra case per 1000 women).Heart disease – may decrease the risk of heart disease if started within 10 years of menopause or before the age of 60.Breast cancer - overall 1 in 8 women will develop breast cancer during her lifetime. Studies suggest that there is either no increase, or a very small added risk of breast cancer when using oestrogen only MHT. Breast cancer risk is lower with oestrogen only MHT compared with oestrogen plus progestogen.Stroke – no increased risk for women without underlying stroke risk factors who are in their 50s or during the first 10 years of menopause. Women with risk factors can probably safely use a patch or gel form of treatment.Vaginal oestrogen therapyVaginal oestrogen therapy is useful for women who have local symptoms such as vaginal dryness. Safety fact:If used as supplied, vaginal oestrogen therapy is safe to use long-term, except after breast cancer.TiboloneTibolone is taken as a single tablet and has some oestrogen, progesterone and testosterone effects. Many, but not all, women find tibolone helps with symptoms and may also improve sexual function. Tibolone is also suitable to reduce the risk of osteoporosis (thinning of the bones) in post-menopausal women.Safety facts:Blood clots – no increase in risk.Heart disease – no increase in risk.Breast cancer – reduces breast density/tenderness and no increase in breast cancer risk with three years of use.Stroke – increase in risk if started after the age of 60.Oestrogen combined with a SERMSERMS (selective oestrogen receptor modulators) are a newer treatment option for menopause. They have anti-oestrogen or oestrogen-like effects that vary in different parts of the body.A tablet containing conjugate equine oestrogen combined with the SERM bazedoxifene improves menopausal symptoms, bone density and reduces breast density. Bazedoxifene, like progestogen, reduces the risk of cancer of the lining of the uterus in women who have not had a hysterectomy.Safety fact:SERMs can be combined with oestrogen to improve symptoms, improve bone density and reduce the risk of uterine cancer.Where can you find information about other treatment options?If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Other fact sheets about treatment options include:Non-hormonal treatment options (See AMS fact sheet – Non-hormonal treatment options for menopausal symptoms)Lifestyle changes and menopause (See AMS fact sheet – Lifestyle and behaviour changes to manage menopausal symptoms)Complementary therapies (See AMS fact sheet – Complementary medicine options for menopausal symptoms)Information for your doctor to read includes AMS Information Sheets:Risks and benefits of MHTAMS Guide to equivalent MHT/HRT doses Australia only or AMS Guide to equivalent MHT/HRT doses New Zealand onlyCombined MHTOestrogen only MHTTibolone for post-menopausal women

Read more on Australasian Menopause Society website

Menopausal hormone therapy | Better Health Channel

Hormone replacement therapy (HRT) can reduce menopausal symptoms, but the benefits and risks need to be considered carefully.

Read more on Better Health Channel website

HRT | Intersex Peer Support Australia

Read more on InterAction for Health and Human Rights website

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