Taking HRT

How you take hormone replacement therapy (HRT) depends on what type you have. You can HRT as tablets or through your skin (transdermal) using patches, gel or spray.

Everyone reacts differently to HRT. No preparation is better than any of the others. It is often a personal choice which you try first.

HRT preparations

Tablets

You take tablets once a day. They help with the short-term symptoms of menopause. There are different tablets available.

Patches

You apply HRT patches once or twice a week to any area below the waist. They help with the short-term symptoms of menopause.

Gel

Oestrogen is available as a gel that you use once a day. You put the gel on a clean, dry and unbroken area of skin. It usually goes on the upper arm, shoulder or inner thigh.

You rub in the gel and it takes a few minutes to dry. The gel is clear and not greasy.

If you have a womb, you also need to take progesterone to protect the womb lining. You may have this as tablets or an IUS (intrauterine system), such as Mirena®. Your doctor or nurse can give you more information about an IUS.

Spray

This is oestrogen only. You apply it to your forearm (between your wrist and elbow) once a day. Use 1 to 3 sprays and leave it to dry for 90 seconds.

Vaginal oestrogen (local HRT)

Vaginal creams, vaginal tablets, vaginal rings or vaginal pessaries (a device put in the vagina) contain a small amount of oestrogen. This type of HRT only works for specific symptoms in the area where you put them, such as vaginal dryness and urinary symptoms.

Local HRT does not help other symptoms, such as hot flushes. It also does not protect against the longer term effects of the menopause, such as osteoporosis (a condition that weakens the bones).

Local HRT does not have the same increased risks as other types of HRT, so most people can use it.

How long HRT takes to work

It usually takes a few weeks before you feel the benefits of HRT. It can take up to 3 months to feel the full effects. 

If you have not felt the benefit of HRT after 4 to 6 months, it may help to try a different type.

It can take your body time to get used to HRT. When you start HRT, you might have side effects. Examples are tender breasts, feeling sick (nausea) and leg cramps. These side effects usually disappear within 6 to 8 weeks.

If you forget to take the medicine

If you forget to take your HRT medicine, do not take the doses that you have forgotten. Just take the next dose when you remember.

How long you take HRT

If you have HRT to help with menopausal symptoms, you should take it for 2 to 3 years.

To get the best benefit in reducing the risk of osteoporosis, you need to take HRT for at least 5 years.

If you had an early menopause or surgery to remove your ovaries, the time is not counted until you reach the age of 50. This is the average age of the menopause. 

You can talk about stopping or lowering the amount of HRT that you take with your doctor. Each year, you and your doctor review the benefits and risks of continuing to take HRT.