As women approach menopause, the level of female hormones begins to drop. This results in uncomfortable symptoms like vaginal dryness, low sex drive and hot flushes. Hormone replacement therapy (HRT) replenishes these female hormones and relieves the symptoms effectively.
| 51 years | 1 in 10 | 51% |
| old is the average age for a woman to reach the menopause in the UK | women experience menopause before they reach age 40 | of women surveyed said that menopause had affected their sex lives |
Menopause occurs when a woman's ovaries stop producing and releasing an egg every month. This means that the woman will no longer have monthly menstruation, nor will she be able to conceive. On average, menopause occurs in women in their 50s. However, some women go through menopause in their 40s and a small percentage of women, in their 30s.
Menopause is not the same for all women. Depending on the severity, the symptoms vary. Some of the symptoms that significantly affect a woman's quality of life include:
Vaginal dryness
Hot flushes
Low sex drive
Issues with memory
Insomnia and night sweats
Anxiety and inability to focus
Hormone replacement therapy (also known as HRT) is a treatment taken by women when they begin to show signs of menopause. HRT treatments are designed to replenish the female hormones, which the menopausal women have stopped producing. HRT helps relieve the menopausal symptoms and allow the body to return to normal.
The menopause medication contains the female hormones – oestrogen and progestogen. Oestrogen is responsible for many functions in a woman's body. When the level of this hormone drops, the woman starts experiencing menopause symptoms. A drop in the oestrogen level can also lead to osteoporosis. Therefore, it is important to keep these hormone levels up. HRT medication replenishes these hormones and wards off the uncomfortable symptoms.
The hormone progestogen is responsible for maintaining womb health and keeping certain cancers at bay. A drop in this hormone doesn't cause the menopause symptoms, but it's important to keep these hormones at a healthy level for better uterus health. However, if the woman has already had a hysterectomy (uterus removal), she can take an oestrogen-only HRT medication.
The main benefit of HRT is that it helps alleviate most of the symptoms of menopause, such as:
Night sweats
Hot flushes
Vaginal dryness
Mood swings
Reduced sex drive
The weakening of the bones. Osteoporosis is very common after menopause
HRT may not be suitable in women with:
A history of?ovarian cancer?breast cancer, or?womb (uterus) cancer
A history of?heart disease?or?stroke
A history of?blood clots
Liver disease
Untreated?high blood pressure. The blood pressure has to be controlled before you can start HRT.
Pregnancy
HRT Hormones
HRT?replaces the hormones that a menopausal woman is no longer producing. HRT uses two hormones:
Oestrogen: Types of oestrogen are oestradiol, estrone, and estriol
Progestogen: Synthetic version of the hormone?progesterone are medroxyprogesterone, norethisterone, dydrogesterone, and levonorgestrel
HRT treatment involves taking both these hormones, called combined HRT or just taking hormone oestrogen, called as oestrogen-only HRT.
Most women are prescribed combined HRT because taking oestrogen-only HRT can increase the risk of developing endometrial (womb) cancer. When HRT is combined with progestogen, it minimises the risk.
However, oestrogen-only HRT is usually prescribed for women whose womb has already been removed during a?hysterectomy.
HRT can be taken in different forms. Talk to your GP to decide on the best HRT form of treatment for you.
Tablets?
Tablets are usually taken once a day and are one of the most common forms of HRT. Both oestrogen-only and combined HRT medications are available as tablets.
Skin Patches
Skin patches are also a convenient form of taking HRT. You just have to stick them to your skin and replace them every few days. Both oestrogen-only and combined HRT?patches are available.
Oestrogen Gel
Like skin patches, oestrogen gel is a convenient way of taking HRT. But, if you still have your uterus, you'll have to take progestogen separately to reduce the risk of womb cancer.
Implants
These small pellet-like implants are inserted under?your skin (usually in the?tummy area) after your skin is numbed with local anaesthesia.
The implant?releases oestrogen gradually and lasts for several months before needing a replacement. But if you still have your uterus, you'll need to take progestogen too.
Vaginal oestrogen
Vaginal oestrogen is available in various forms that can be placed inside your vagina:
Creams
Tablets
Rings
Pessaries
Vagina oestrogen helps in relieving vaginal dryness, but not other symptoms like hot flushes. It doesn't carry the usual HRT risks of breast cancer. Hence, it can be taken without progestogen, even if you still have your uterus.
The HRT medications available at MedsNow are:
Elleste, Premique, Lival, Femoston, EvorelSequi, Evorel Conti, Evorel, Estradot, Elleste, Solo MX, Elleste Duet, Zumenon
Oestrogen-Only HRT: This treatment routine is only recommended for women who have had their womb removed (hysterectomy). Taking oestrogen alone carries a risk of developing endometrial cancer. But in women with no womb, this is not a concern.
Cyclical (or Sequential) HRT: This HRT treatment routine is usually recommended for women who are taking combined HRT for the menopausal symptoms but still have their?periods.
Cyclical HRT is of two types:
Monthly HRT: Monthly HRT is recommended for women having regular periods. Oestrogen has to be taken every day, and progestogen has to be taken for the last 14 days?of your menstrual cycle.
3-Monthly HRT: This HRT treatment routine is recommended for women who have irregular periods (you should have a period every 3 months). Oestrogen has to be taken every day, and progestogen has to be taken for around 14 days every 3 months.
Continuous Combined HRT
If a woman hasn't had her periods for a year, she is classed as being a post-menopausal woman. Continuous combined HRT is usually prescribed for post-menopausal women. In continuous combined HRT, the woman has to take oestrogen and progestogen every day without a break.
Some HRT side effects include:
bloating
fluid retention
depression?
headaches
breast tenderness or swelling
Possible health risks associated with the administration of HRT include:
An increased risk of endometrial cancer?(only if the woman still has her uterus and is not taking a progestogen along with oestrogen)
Increased risk of blood clots and stroke
Increased chance of gallstone/gallbladder problems
Increased risk of dementia if HRT initiated after the woman has been in menopause for 10 years
Does HRT cause weight gain? Most women believe that taking HRT will make them gain weight, but there is no evidence that supports that claim. Weight gain is common during menopause, whether or not you are on HRT. However, eating healthy and exercising regularly can help you lose unwanted weight.
Where to put the HRT patch? Apply the patch?to a clean, dry, oil-free and hair-free area of the upper buttock or lower stomach. Keep the patch firmly pressed for 10 seconds.
How long do HRT side effects last? When HRT treatment begins, you may experience side effects such as nausea, leg cramps and breast tenderness. These side effects may disappear with 6 to 8 weeks.
Can I buy HRT over the counter UK? No. HRT is a prescription-only medication.
What age can you start hormone therapy? Hormone replacement therapy should be started before the age of?60?or within?10 years?of menopause.
What are the alternatives to HRT? The alternatives to HRT can be broadly classified as:
Herbal medicine: Plants and plant extracts are used to relieve the symptoms. For e.g. St John's Wort or evening primrose oil
Non-hormonal medical treatments: Doctor prescribed medicines such as antidepressants
Alternative medicine: Instead of conventional medicines, a wide range of therapies such as acupressure, homoeopathy, and acupuncture are used. For e.g. aromatherapy with HRT
Does HRT make breasts bigger? Your breast?density may increase when you are on hormone replacement therapy. The combination of oestrogen and progestogen?increases breast?density more than oestrogen alone.
How will I feel when I am on HRT? When you start taking HRT, you may feel some side effects such as nausea, breast tenderness, and leg cramps.
Is HRT gel better than patches? Oestrogen?gel is a popular form of HRT. It has to be rubbed onto the skin once a day. Like skin patches, HRT gel is a convenient form of HRT, and it does not increase the risk of blood clots.
At what age should a woman stop taking hormone replacement therapy? If you are over 59years or have been on HRT for 5 years, talk to your doctor about quitting HRT.
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