HRT is a treatment that replaces the oestrogen your ovaries produce less of during perimenopause and after menopause. Some types also include a progestogen (progesterone-like hormone) to protect the lining of the womb.
HRT is the most effective treatment for hot flushes and night sweats and can also improve sleep, mood, joint aches and vaginal symptoms for many women.
Who can use HRT?
Many women can use HRT safely, including those with troublesome menopause symptoms or early menopause. Your suitability depends on your symptoms, medical history, and personal preferences.
HRT can be considered for most healthy women under 60, or within 10 years of menopause, as benefits usually outweigh risks.
Benefits of HRT
- Relieves hot flushes and night sweats.
- Improves sleep and quality of life.
- Helps genitourinary symptoms such as vaginal dryness and urinary discomfort.
- Reduces risk of osteoporosis and fractures by supporting bone strength.
- May reduce risk of type 2 diabetes when started around menopause.
What are the risks?
Risks vary depending on the type of HRT, how long it is used, your age, and your health background. For most women starting HRT around menopause, the absolute risks are small.
Combined HRT (oestrogen plus progestogen) is linked to a small increase in breast cancer risk with longer use. Oestrogen-only HRT (for women without a womb) does not increase breast cancer risk and may slightly reduce it.
Oral HRT tablets slightly increase the risk of blood clots and stroke; this risk is lower with transdermal HRT (patches, gels or sprays).
Common side effects when starting
- Breast tenderness.
- Bloating or mild nausea.
- Headache.
- Breakthrough/unscheduled bleeding in the first months.
- Skin irritation with patches.
Review and follow-up
We normally review HRT about 3 months after starting or changing a dose, and then at least yearly. Your plan can be adjusted over time to keep benefits high and side effects low.
