Menopause is a natural occurrence when a woman stops menstruation and is unable to conceive naturally.

The average age of a woman to start the menopause in the UK is 51 but it can occur between the ages of 45 and 55 when a women’s oestrogen levels start to decline.

Most people are aware of some of the common symptoms of the menopause such as hot flushes, night sweats, fatigue and mood changes which can start months or sometimes years before your periods stop, and last for around 4 years after. You can visit your GP if your symptoms are bothering you, or if you’re experiencing any of these symptoms before the age of 45, for treatment.

In this blog, we share an overview Hormone Replacement Therapy - the most common treatment option for menopause, as well as some other ways to help manage your body through it.

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What is Hormone Replacement Therapy (HRT)?

HRT is a treatment for menopause that replaces the female hormone oestrogen in the body that are at lower levels when you approach the menopause. This therapy can help relieve most of the menopause symptoms as well as helping prevent bones to become weakened which is common after menopause.

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Hormone Replacement Therapy: Benefits vs risks

The benefits of taking HRT usually outweigh the risks for women going through the menopause as it helps them to relieve often uncomfortable symptoms such as hot flushes, mood swings and night sweats. The risks are normally small and will depend on the type of HRT you are prescribed and whether or not you have any other underlying health conditions.  

Some side effects such as headaches, breast tenderness, feeling sick and abdominal pain are all common and usually pass within three months of starting HRT.

Women who take HRT for more than one year have may have a slightly higher risk of developing breast cancer than women who never use HRT. The risk depends on many things such as the type of HRT, how long you take it for, your age and general health. After you stop taking HRT, the risk decreases but some risk can remain for more than 10 years.

To read more about the risks of HRT, read the guidance from the NHS here.

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Getting Started with Hormone Replacement Therapy

Most women can take HRT, including those without a womb. Exemptions would include if you have a history of breast, ovarian or womb cancer; a history of blood clots; untreated high blood pressure; you have liver disease or you are pregnant.

As soon as you start experiencing menopause symptoms, visit your GP. There are different types of HRT available so it’s best to speak to your GP who can help advise which one is suitable for you. Usually, you will start on a low dose for a few weeks to allow it to take effect. The dose may be increased however it’s recommended you stay on treatment for three months before changing the dose.

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Types of HRT

The treatment you receive is dependent on whether you are perimenopausal, postmenopausal, the route of administration and your personal wishes. HRT treatment can vary not only in the different hormones you receive, but also the method of treatment and the treatment plan.

For example, most women will take a combination of both oestrogen and progesterone hormones together. If you do not have a womb, you can take oestrogen on its own.

Your GP can advise you best and you may need to try more than one type of treatment before you find the right one for you.

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Below is a summary of the different types of HRT:

• Tablets. One of the most common forms and simplest, tablets are taken once a day. Tablets come as both combined hormone HRT or oestrogen-only. Some of the risks with HRT are higher with taking tablets, such as increased risk of blood clots. However, the overall risk is still small.

• Skin patches. This treatment option is also common, and patches are replaced every few days. Skin patches also help avoid some of the side effects such as indigestion and they do not increase your risk of blood clots.

• Gels. HRT gel contains oestrogen and is applied to the skin once a day. It is convenient and like the skin patches, does not increase your risk of blood clots. If you have a womb, you will also need to take progesterone separately to reduce your risk of womb cancer.  

• Vaginal oestrogen. This is available as a cream, pessary or ring that is placed inside the vagina. This method can help with vaginal dryness but not other symptoms such as hot flushes. In addition, it does not increase your risk of breast cancer and you can use it without taking progesterone.  

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Stopping HRT

Most women stop taking HRT when their symptoms have passed but there is no limit on how long you can take it for. It’s recommended you speak to your GP about how long you should be on treatment for and you can stop HRT either gradually or suddenly. Stopping HRT suddenly can exacerbate side effects. By decreasing your dose slowly over time, menopause symptoms are less likely to come back. If symptoms persist months after you have stopped HRT or are severe, contact a GP who can advise you further.

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If you have any questions on treatment for menopause or hormone replacement therapy in general, get in touch with our friendly pharmacy team who can offer you advice and guidance.