Hormone Replacement Therapy

Hormone Replacement Therapy (HRT): A Simple Guide

Hormone replacement therapy, or HRT, is a medicine that replaces the hormones your body makes less of during menopause. It mainly replaces estrogen. It is the most effective treatment for hot flashes and night sweats, and it helps protect your bones. HRT is not right for everyone, so it is always prescribed by a doctor after checking your health.

Please note: This page shares general health information in simple words. It is not medical advice. Every body is different, so talk to a doctor or gynaecologist before you try any treatment.

Key Facts About HRT

  • HRT replaces estrogen, and often progesterone too.

  • It is the most effective treatment for hot flashes and night sweats.

  • It also helps prevent weak bones.

  • It comes as tablets, skin patches, gels and sprays.

  • Low-dose vaginal estrogen can treat vaginal dryness.

  • HRT has some risks. A doctor will help you weigh them up.

What Is HRT?

During menopause, your ovaries make much less estrogen and progesterone. This causes symptoms like hot flashes, night sweats and vaginal dryness.

HRT gives back some of these hormones. This eases symptoms and helps your body adjust. Doctors may also call it menopausal hormone therapy, or MHT.

What Are the Types of HRT?

There are two main types:

  • Combined HRT. This has estrogen and a form of progesterone called progestogen. It is for women who still have a womb. The progestogen keeps the lining of the womb safe. Estrogen on its own can make the lining too thick and raise the risk of womb cancer.

  • Estrogen-only HRT. This is for women who have had their womb removed.

There is also vaginal estrogen. This is a low-dose cream, tablet or ring used inside the vagina. It treats vaginal dryness and some urine problems.

How Is HRT Taken?

HRT comes in different forms:

  • Tablets you swallow

  • Skin patches

  • Gels you rub on the skin

  • Sprays

  • Vaginal creams, tablets or rings

Your doctor will help you pick the best one for you. For example, patches and gels may be better for women who have a higher risk of blood clots.

What Are the Benefits of HRT?

HRT can ease many menopause symptoms. It can help with:

  • Hot flashes and night sweats

  • Trouble sleeping

  • Low mood and anxiety

  • Vaginal dryness

  • Muscle strength

HRT also helps prevent osteoporosis. This is a condition where bones become weak and break easily. This is very important for women who have early menopause.

What Are the Risks of HRT?

For most women under 60, the benefits of HRT are greater than the risks. But it is good to know the risks:

  • Breast cancer. Combined HRT slightly raises the risk. The risk grows the longer you take it and falls after you stop. Estrogen-only HRT has little or no extra risk.

  • Blood clots. HRT tablets slightly raise the risk. Patches, gels and sprays do not.

  • Stroke. Tablets slightly raise the risk. The risk is still very low for women under 60.

  • Heart disease. HRT has little or no effect on heart disease risk.

Vaginal estrogen does not carry the same risks as other HRT, because very little goes into the blood.

Who Should Not Take HRT?

HRT may not be safe if you:

  • Have had breast, ovarian or womb cancer

  • Have a high risk of breast cancer

  • Have bleeding from the vagina that has not been checked by a doctor

  • Have had blood clots, unless your doctor advises a safe form

  • Have untreated high blood pressure

  • Have liver disease

  • Are pregnant

Your doctor will check your health and family history before prescribing HRT.

What Side Effects Can HRT Cause?

Not everyone gets side effects. When they happen, they are usually mild and include:

  • Sore breasts

  • Headaches

  • Feeling sick

  • Mood changes

  • Spotting or light bleeding

These usually go away within 3 months. Tell your doctor if they do not.

How Soon Does HRT Work and How Long Can You Take It?

Symptoms often start to get better within a few days or weeks. Your doctor will usually check how you are doing after about 3 months.

There is no fixed time limit for HRT. Your doctor will review it with you each year. Women with early menopause are usually advised to take HRT until at least age 51. Do not stop HRT suddenly without talking to your doctor.

What If You Cannot Take HRT?

There are other options:

  • Non-hormonal medicines a doctor can prescribe

  • Talking therapy called CBT (cognitive behavioural therapy)

  • Lifestyle changes, like keeping cool, staying active and avoiding triggers

Sirona Products for Everyday Comfort

Some women use simple comfort products, with or without HRT. Sirona Cooling Mist gives the skin a cool feeling during a hot flash. The Sirona Menopause Intimate Cream is a hormone-free cream for dryness on the skin around the vagina. These do not replace hormones or work like HRT.

When Should You See a Doctor About HRT?

See a doctor or gynaecologist if:

  • Menopause symptoms affect your sleep, work or daily life.

  • Your periods stop before age 45.

  • You want to know if HRT is safe for you.

  • You are on HRT and get bleeding that is heavy, frequent or new.

  • You have chest pain, a painful swollen leg or sudden breathlessness. Get urgent medical help for these.

Related Terms

Shop menopause care: Sirona Menopause Collection

Sources

  1. NHS. About hormone replacement therapy (HRT). https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/about-hormone-replacement-therapy-hrt/

  2. NHS. Side effects of hormone replacement therapy (HRT). https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/

  3. NHS. Benefits and risks of hormone replacement therapy (HRT). https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/benefits-and-risks-of-hormone-replacement-therapy-hrt/

  4. NHS. When to take hormone replacement therapy (HRT). https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/when-to-take-hormone-replacement-therapy-hrt/

  5. NICE. Menopause: identification and management (NG23). https://www.nice.org.uk/guidance/ng23

Disclaimer: This page is for general information only. It is not a substitute for advice, diagnosis or treatment from a qualified doctor. It was written by the Sirona Content Team using the trusted medical sources listed above. Always talk to your doctor or gynaecologist about your symptoms and before starting any medicine, supplement or product. If you have heavy bleeding, chest pain, trouble breathing or severe pain, get medical help right away.