What is HRT?

Hormone replacement therapy (HRT) replaces the hormones that the ovaries stop producing at the time of the change (menopause - see also the Menopause information leaflet ref #28).

Hot flushes and night sweats respond well to HRT and usually disappear within a few weeks of starting treatment. HRT also helps dryness of the vagina and it can dramatically reduce the development of bone loss (osteoporosis) and the likelihood of fractures.
In women who do not smoke it can reduce the threat of heart disease and strokes by up to 50%.

How can HRT be taken?

Tablets
Oestrogen tablets are taken every day of the month. If you have not had a hysterectomy, you will also need to take an additional tablet of the other female hormone progesterone which will give you a monthly bleed. This is very important as this bleed protects the lining of the womb from cancer.
Patches
There are patches containing oestrogen only, or double ones of oestrogen and progesterone. A patch is stuck to the skin and must be changed every three to four days. It works by releasing hormones through its membrane and into the skin at a controlled rate.
Implants
An implant consists of a pellet inserted under the skin where it releases hormones for a period of 4 to 8 months. This can be done at the Health Centre by your GP, after you have been given a prescription and collected the implant from the chemist

When should you start HRT?

The average age at which the menopause occurs is 52. However, this obviously varies from person to person. If you have an early menopause you are particularly in need of HRT. Other factors to consider are whether your mother had an early menopause and whether you have had an early hysterectomy.

How long should you use HRT?

For the short term symptoms, such as hot flushes and night sweats, treatment for one to two years is often enough. To prevent oesteoporosis and heart disease most Doctors agree that 5 to 10 years treatment is best.

What are the side effects?

Most side effects are minor and often disappear. About one in ten women experience leg cramps, tender breasts, slight nausea or weight gain when they start treatment. Many women continue to have a menstrual type blood loss.

There is no evidence that HRT increases the risk of cancer of the cervix; similarly most Doctors agree that HRT does not increase the risk of breast cancer if used for five to ten years.

What about contraception?

HRT is not a contraceptive. You will need contraception for one year after the last menstrual period if you are over 50 years of age and for a further two years if you are under the age of 50.

If you are interested in starting HRT and want additional advice, you can contact the Practice Nurse, make an appointment with the Well Women Clinic or talk to your GP.

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