Hormone Replacement Therapy (HRT)

HRT is an available treatment to replace, or top-up, a woman’s levels of the hormone, oestrogen, which decrease during the menopause.

Oestrogen on its own provided no protection against the possibility of uterine cancer, so a synthetic hormone, progestegen, is added to the HRT preparation.

Assorted health scares have caused its popularity to rise and fall, and its effect is akin to a lottery.

If I prescribe HRT for five women, I find it causes unacceptable risks for two of them, makes no difference for two others, and is effective for one woman - Dr K. Anderson (Birmingham)
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If you have had a hysterectomy, you will not run the risk of endometrial cancer and therefore tablets containing only oestrogen will be prescribed.

Frequently Asked Questions

Q. Will my doctor do any tests before prescribing it?

A. Your doctor should examine you thoroughly before prescribing HRT, especially your breasts and pelvis, and check your blood pressure. If it is prescribed, then a first critical review should be arranged at the end of 12 weeks treatment.

It may not be suitable if you have a history of the following conditions :

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Q. What types of HRT are available?

A. It is available as tablets, patches, hormone implants and nasal sprays as well as oestrogen vaginal creams and vaginal rings.

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Q. What are the benefits if I take HRT for menopausal symptoms?

A. You are likely to find an improvement in the frequency and severity of hot flushes and night sweats, maybe within a week. This often has a ‘knock-on’ effect, in that your sleeping patterns will improve which in term will reduce any daytime irritability, mood swings etc.

I was started on HRT in the form of tablets. These produced high blood pressure and headaches so I was changed to patches. They changed my life - the night sweats and flushes disappeared, as did the pain in my vagina - Annette (Brunei)
I had awful night sweats and within days of going on HRT, I felt a different person. I had so much more energy.I hadn’t realised I was lacking it as I think it tends to build up gradually and you get used to it - Lynn (Wales)

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Q. What about side-effects?

A. HRT causes ‘start-up’ effects which usually recede, and you are highly likely to experience some, or all,of the following:

Infrequent or rare reactions include :

  • Diarrhoea
  • Gastro-intestinal upsets
  • Muscular or joint pains
  • Scalp hair loss
  • Increased blood pressure
  • Sensitivity to light
  • Vaginal bleeding
  • Breathing disorders
  • Depression
  • Acne
  • Pains or swelling in upper leg
  • Skin rash
  • Heart palpitations
  • Swollen ankles
  • Migraines
If you experience any of these, you should see your doctor and discuss the situation, rather than waiting for your first critical review.

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Q. How long can I use HRT for menopausal symptoms?

A. This will depend on your symptom relief. Some women decide to take it for six months, then discontinue it for a few months and see what difference this makes to their well-being. The symptoms may return during this time, as HRT frequently ‘damps’ them down, especially if they are severe. So you might decide to :

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Q. I have heard that HRT causes breast cancer. Is that true?

A. It is certainly true that

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Q. What about taking HRT post-menopausally?

A. Some doctors are cautious, and believe that all HRT should be discontinued by 10 years after periods cease, mainly because of the risk of breast cancer in women from their 60s onwards.Certainly, its continuing use after the age of 50 should be be critically reviewed every 5 years. Having said that, it is not unknown for much older women to be taking it.

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