HRT stands for hormone replacement therapy and includes the hormones oestrogen/oestradiol, often
progestogen and in some cases, testosterone.
Oestrogen/oestradiol can be replaced as a tablet, gel, patch or spray. The type of oestrogen mostly used is 17 betaestradiol, which is similar to the one your own body produces and It is derived from the yam root vegetable. This is often referred to as ‘body identical’ HRT.
If you still have a uterus (womb), then you will need to take a progestogen to help protect the lining of the womb oestrogen and progesterone together are known as ‘combined HRT’. The safest type of replacement progestogen is called micronized progesterone branded as 'Utrogeston' in the UK and it comes in a tablet form.
An alternative way to receive a progestogen is to have the Mirena coil inserted into your uterus. This is a great option for any women also needing contraception as it is a very effective method of preventing pregnancy.
The Mirena or ‘IUS” needs to be replaced every 4/5 years in order to protect the uterus properly.
For some women, oestrogen replacement alone is not enough to manage their symptoms and testosteronecan be trialled alongside the oestrogen therapy in this situation.
It needs careful monitoring with blood tests, and it is available in a gel or a cream in the UK. (This is known as the transdermal route).
While it is not currently licensed as a treatment for women in the UK, it is widely and safely used by doctors but unfortunately, it is not prescribed on the NHS at present.
What are the benefits of HRT?
Your symptoms will improve – not usually overnight but some quicker than others!
Most women report a significant improvement in symptoms within 3-6 months of starting HRT and this is why making any drastic changes to treatment before 3 months is not advised.
Your risk of osteoporosis will reduce – osteoporosis can put you at risk of shrinking in height as we get older and suffering broken bones if we fall.
Your risk of cardiovascular disease will reduce as oestrogen protects the blood vessels in the body, reducing the risk of stroke, dementia and heart attacks.
Your risk of type 2 diabetes is reduced.
Your risk of osteoarthritis and joint pains is reduced. HRT may protect you from bowel cancer.
HRT helps mood, memory and concentration and as such reduces anxiety and depression. HRT helps you sleep.
HRT can improve libido, help vaginal dryness and soreness during intercourse and improve sexual satisfaction.
What are the risks?
For most women who start taking HRT within 10 years of their last period, the benefits of HRT are far greater than the risks of being oestrogen deficient.
Taking combined HRT (oestrogen and progestogen) tablets may be associated with a small risk of developing breast cancer if taken for over 10 years.
Side effects with HRT are uncommon but when you first start HRT, these can include breast soreness, irregular bleeding or ‘spotting’.
Sometimes women report PMS type symptoms and some women complain of fluid retention.
Side effects often settle with time but if they don’t, alternative preparations of HRT can be tried after discussion with your Doctor.