Hormone replacement therapy (HRT) is a common treatment for easing menopause symptoms, like hot flashes, brain fog, joint pain, low mood and low libido. But how does it work and what are the signs you need hormone replacement therapy? Read on to find out. Quick facts: HRT explained Hormone Replacement Therapy for menopause is a treatment that uses hormones to relieve the symptoms of menopause and to prevent health problems that can occur after menopause.  The hormones commonly used in HRT are oestrogen, progesterone and sometimes testosterone. It does what it says on the tin—replaces the hormones that are declining in your body during this natural part of ageing, with synthetic or bioidentical hormones. These hormones mimic your natural hormones, relieving symptoms.  HRT can be taken in a variety of ways, including pills, patches, gels, sprays, vaginal cream and pessaries. The best method to take HRT will depend on your individual needs, preferences and medical history. Do you need HRT? You can take HRT to relieve menopause symptoms if you’re in perimenopause (the years leading up to menopause before your periods stop) or postmenopause.  Challenging symptoms like brain fog, night sweats, vaginal dryness, reduced sex drive, insomnia and concentration issues can interrupt your daily life. Hormone replacement therapy helps to restore hormonal balance to provide relief. Whether or not you’ll need HRT will depend on your symptoms and physiology and is always a personal choice. For personalised advice, you can book an appointment with one of our Menopause Specialists.  They can prescribe HRT based on your individual needs and preferences and can offer expert guidance on navigating symptoms and treatment options. Different types of HRT There are different types of HRT to choose from. Which type is right for you will depend on: HRT options can contain different hormones, including oestrogen, progestogen, a combination of both, and sometimes testosterone. HRT can be taken in different ways tablets, including patches, gels, sprays, implants, coils, or creams. It can also be taken using different regimens, including cyclical or sequential treatments, or continuous treatments.  Tablets Tablets are one of the most common ways of taking HRT. You usually take them once a day. Tablets are available in both oestrogen-only and as combined HRT.  Although it’s small, the risk of developing blood clots is higher with tablets compared to other HRT methods like patches, gels and sprays. Skin patches HRT patches are available in both oestrogen-only and combined. They are stuck to the skin, usually on the lower half of your body, and gradually release small amounts of hormones through the skin. You’ll usually change your skin patch every few days. Patches could be a preferred option if you have difficulty swallowing tablets, get indigestion or are likely to forget to take tablets. Some patches can leave marks and cause redness or irritation. Oestrogen skin gels and sprays You apply oestrogen-only skin gels by smoothing them onto your skin. Apply sprays by spraying them on the inside of your arm or thigh once a day. Your body absorbs the oestrogen gradually. Vaginal oestrogen Low-dose vaginal oestrogen is also available in tablets, pessaries, creams or vaginal rings that you insert into your vagina. This can help to provide relief for particular menopause symptoms like vaginal dryness and pain during sex (dyspareunia). Testosterone Like oestrogen and progesterone, menopause also causes your testosterone to decline. This can make you feel tired, unmotivated and low in libido. While testosterone isn’t currently licensed to treat menopause symptoms in the UK, specialists may prescribe it. It’s given in the form of a gel that you can rub over the skin where it’s gradually absorbed. Although uncommon, possible side effects of taking testosterone include acne, unwanted hair growth and weight gain. Intrauterine system (IUS) or Mirena coil If you have a womb and are using oestrogen-only HRT, you’ll need to also take a form of progesterone HRT to protect against endometrial cancer. You can do this with the Mirena coil, an intrauterine system (IUS). Inserted into your womb, the Mirena coil gradually releases progestogen (levonorgestrel) into your body. Once inserted, the Mirena coil can stay in place for up to five years and double up as contraception to prevent pregnancy. Benefits and risks of HRT Like other medications, there are benefits and risks associated with HRT. Benefits of HRT Most of the symptoms of menopause are associated with declining oestrogen levels. People have found that HRT is useful to manage symptoms including:  There are several long-term effects associated with low oestrogen. Taking HRT can help to reduce the risk of: Risks of HRT The risks of any serious side effects are usually very low, and depend on: HRT can slightly increase the risk of breast cancer. If you’ve had breast cancer or have a family history of it you’ll usually be advised not to take HRT.  Currently, the risk of breast cancer when using HRT has been found to be an extra 5 in every 1000 women who take combined HRT for 5 years. The risk increases the longer you take it, and the older you are. It falls again after you stop taking it.  Oral HRT can increase the risk of blood clots and in rare cases, stroke. If your medical history would indicate that you are at an increased risk of blood clots or strokes you should be recommended HRT patches, spray or gel rather than tablets, which have been found to not carry this risk. Weighing up the risks and benefits of taking HRT needs to be considered on an individual basis. It has been found in more recent studies that usually the benefits outweigh the risks and why HRT is now so commonly used. If you haven’t had a hysterectomy, you’ll need to take oestrogen and progesterone combined to protect against cancer. Oestrogen thickens the womb lining which can increase the risk of developing endometrial cancer. Progesterone helps to protect against it by ensuring the lining is shed regularly. The HRT timeline: How long before results? Once […]