Overview

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) is medicine to treat the symptoms of the menopause.

The menopause is when you stop having periods and can no longer get pregnant naturally. Menopausal symptoms include:

  • hot flushes
  • night sweats
  • vaginal dryness
  • feeling tired and irritable
  • lower sex drive

Important

The information on this page is for people who are prescribed HRT medicine. You should read it together with the patient information leaflet from the manufacturer of your medicine. 

How HRT works

Your body stops making a hormone called oestrogen when you go through the menopause, or if you have surgery to remove your ovaries. 

HRT replaces oestrogen to help with the symptoms of the menopause. You can also have HRT if medical treatment causes the menopause (a medical menopause).

If you use HRT in the long term, it can help to lower the risk of bone thinning (osteoporosis) and bowel cancer. However, there are known risks of HRT (such as an increased risk for some types of cancer). 

Your doctor or nurse talks to you about your age, symptoms and medical conditions. They then explain the risks and benefits of HRT that apply to you.

For some people, taking HRT is not an option. This is usually if someone has had a cancer caused by hormones or a blood clot.

You might have heard of bioidentical or 'natural' hormones as another option to HRT. These are not used in treatment because they have not been approved by organisations that regulate medicines. They have not been researched and proved safe to use.

 

Always talk to your doctor if you are thinking about other options to HRT.

Types of HRT

There are 2 types of HRT. The type you take depends on where you are in the menopause, and if your periods have stopped completely for a year.

Oestrogen only (no progestogen)

Oestrogen-only HRT is used if you have had surgery to remove your womb (a hysterectomy) or use an IUS (intrauterine system), such as Mirena®. An IUS is a small plastic device put in your womb to stop you from getting pregnant.

Oestrogen-only HRT does not contain the hormone progestogen to protect the lining of the womb.

Combined HRT (oestrogen and progestogen)

Combined HRT is used if you still have your womb. It can be given in 2 ways.

  • Continuous combined HRT. You take oestrogen and progesterone (a type of progestogen hormone) together once a day for 28 days. This means that you do not have any withdrawal bleeds.
  • Sequential HRT. You take oestrogen only for the first 14 days. Then you take oestrogen and progesterone together for the next 12 to 14 days. This usually results in monthly withdrawal bleeds. 

Information and support

Daisy Network is a charity supporting people affected by premature ovarian insufficiency. 

Women’s Health Concern is a charity that gives women advice and information.

NHS website has more information about HRT.

Menopause Matters has information on the menopause.

Resource number: 3530/VER4
Last reviewed: August 2022
Next review: August 2025

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