Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) involves taking female sex hormones to replace hormones that your ovaries no longer produce after menopause. HRT is very effective in easing many of the symptoms of menopause that women have [1]. It can also help to lower the risk of osteoporosis [2] and prevent some of the long term health problems associated with early menopause.

There are two main types of HRT. The first type contains only oestrogen and is called ‘oestrogen only HRT’. It is used for women who have had a hysterectomy. The other type contains oestrogen and a progesterone – both of the female sex hormones – and is called ‘combined HRT’. It is used if you still have a womb. In addition to these, there are other hormone therapies, such as progestogens and testosterone [3].

There are several ways HRT can be taken, including as a gel that you rub into your skin, tablets or a patch that sticks onto your skin. Deciding which type of HRT to use can be difficult. Your GP or specialist will be able to advise on which type of HRT is most likely to relieve your symptoms, although you may need to try several different types to find one that really suits you.

Side effects
Some women do get side effects with HRT and these will be explained if you choose to use HRT. Usually they are short lived or managed by a simple change of treatment.

Risks
Some women are wary of HRT because it has been reported in the media that it can increase your risk of developing cancer. There is no evidence that HRT or vaginal oestrogen after treatment for cervical cancer stimulates your cervical cancer to grow again [1]. Current research evidence suggests taking HRT can slightly increase your risk of developing ovarian and breast cancer [4]. If you are worried about taking HRT, you should discuss the risks and benefits relating to your individual situation with your doctor. For most women with menopausal symptoms or those thought to be at risk of osteoporosis, the benefits of taking HRT outweigh the risks [5]. You can also find more information on risks on the Cancer Research UK website.

It’s important to remember that if you are in early menopause (ie. under 45) rather than natural menopause, HRT will just be replacing the hormones that would normally be produced at your age. Due to this, it is thought that most women in early menopause would benefit from taking HRT, at least until the predicted age of natural menopause – roughly 52 years of age [5].

Annie's story

Annie

Annie describes her experience of early menopause and HRT:
 
"I hit menopause immediately and was on HRT before I left the hospital. It took a couple of attempts to find the one that suited me best and I would say that it's important for anyone going onto HRT to be assertive with their doctor so that they find the right one, particularly as this can affect your sex life a lot."
 
 
References
  1. Singh P et al., 2010. Hormone replacement after gynaecological cancer. Maturitas 65, 190–197.

  2. Challberg J et al., 2011. Menopausal symptoms and bone health in women undertaking risk reducing bilateral salpingo-oophorectomy: significant bone health issues in those not taking HRT. British Journal of Cancer 105, 22–7.

  3. Dunleavey R, 2009. Cervical Cancer: A Guide for Nurses. John Wiley & Sons, West Sussex, UK.

  4. CRUK, 2015. Hormone replacement therapy does increase cancer risk. www.cancerresearchuk.org/about-us/cancer-news/press-release/2015-10-20-hormone-replacement-therapy-does-increase-cancer-risk. Accessed: 06.11.2015

  5. Panay N et al., 2013. The 2013 British Menopause Society and Women’s Health Concern recommendations on hormone replacement therapy. Menopause International 19 (2), 59–68.

 
Date last updated: 
06 Nov 2015
Date due for review: 
06 Nov 2017

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