What is hormone replacement therapy?

The main types of HRT are based on hormones, such as oestrogen, progesterone and testosterone, that occur naturally in your body.

During menopause, your hormone levels go up and down, resulting in symptoms like hot flushes and night sweats.

HRT helps restore your hormone levels, which may improve some menopause symptoms.

How is it used?

HRT can be taken as:

• oral tablets
• gels or patches (hormones are absorbed through the skin)
• creams and tablets that are placed in your vagina
• an intrauterine device (IUD)

What are the benefits of HRT?

HRT is usually helpful if you experience problems with hot flushes and night sweats. Mood, sleep and sex drive problems may also improve. Some women also say they find improvements in joint aches, vaginal dryness and incontinence.

What are the risks of HRT?

The main risk is that some types of HRT lead to a slightly increased risk of developing breast cancer or thrombosis (blood clots in the legs or lungs). However, it can prevent other conditions such as osteoporosis, heart disease, fractures, diabetes and some types of cancers.

Current international recommendations say that the benefits outweigh the risks in women who are having significant symptoms from menopause, and that HRT is effective and safe for most healthy women.

Some women have side effects such as nausea, fluid retention, bloating, breast tenderness and swelling, and irregular bleeding. These often go away with time.

HRT may not be suitable for you if you have or have had:

• breast cancer
• endometrial cancer
• cardiovascular disease
• blood clots in the legs or lungs
• stroke
• ovarian cancer
• abnormal vaginal bleeding
• abnormal liver function
• gallbladder problems
• high cholesterol
• diabetes
• high blood pressure

The risks of HRT depend on your age, the type and dose of hormone therapy you take, duration of treatment, and your medical history.

Talk to your doctor to find out which risks apply to you. If you are unable to take HRT, your doctor may suggest other medications that may be helpful.

How to reduce the risks associated with HRT

You can minimise the risks associated with HRT by:

• taking it for less than 5 years and at the lowest effective dose. Review the dose regularly with your doctor and stop as soon as you don’t need it any more
• exercising regularly, not smoking, limiting alcohol consumption and keeping to a healthy weight
• taking good care of your high blood pressure and diabetes, if these affect you

If you are interested in taking HRT, please talk to your doctor to see if it is right for you.