HRT and Menopause Treatment
Manage menopause symptoms and restore hormone balance with hormone replacement therapy (HRT):
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Wide range of treatment options available, including tablets, patches, and creams.
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Relieve hot flushes, mood changes, night sweats and more.
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Get expert advice with a registered doctor from the comfort of your home.
Menopause (‘the change’) is a natural stage in a woman’s life that usually happens when periods stop and is caused by a decline in hormone levels (particularly oestrogen). Menopause typically happens between the ages of 45 and 55, with the average age of menopause in the UK being 51. However, it can happen earlier because of medical conditions, treatments, or naturally occurring early menopause.
During menopause, many women experience symptoms that can affect their daily life, including:
- hot flushes
- night sweats
- mood changes
- sleep issues
- vaginal dryness
Hormone replacement therapy (HRT) is an effective treatment for managing menopause-related symptoms. HRT works by replacing the hormones that are lost during this transitional life stage. At Superdrug Online Doctor, we offer a range of HRT treatments, including popular options such as Gina, Evorel Conti, and Evorel Sequi.
If you’re not sure you have reached menopause yet, our at-home menopause test kit can measure your hormone levels to give you a definitive answer.
You can request HRT from Superdrug Online Doctor by completing a short medical questionnaire for one of our doctors to review. If your treatment request is approved, we can discreetly send it to your home address or you can choose to collect it from your local Superdrug Pharmacy in as little as 2 to 3 hours after a doctor’s approval.
Available Treatments and Test Kits
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Delivery Options
How it Works
About HRT and Menopause Treatment
What is menopause and hormone replacement therapy (HRT)?
Menopause occurs when your periods stop and you can no longer get pregnant because of low hormone levels. It usually affects anyone who has periods aged between 45 and 55, although it can happen earlier. In the UK, the average age of menopause is 51.
During this time, your ovaries stop working as they did before – they produce less or no oestrogen, as a result, they no longer release an egg (ovulation) and your monthly periods eventually stop. During this period of declining hormone levels, 80 to 90% of women will experience menopause symptoms like hot flushes, night sweats, and vaginal dryness.
Hormone replacement therapy is a treatment that can relieve menopause symptoms by replacing the hormones your body produces less of as you go through menopause. The usual hormones that are prescribed are:
- oestrogen to relieve symptoms like hot flushes and vaginal irritation
- progesterone to protect you from womb cancer if you still have a womb and take oestrogen HRT
- testosterone can be prescribed off-label to improve your sex drive and energy levels
HRT is available in several forms according to your symptoms and needs, such as:
- tablets
- creams
- patches
- gels
- sprays
- vaginal rings
- pessaries
HRT can also be:
1: Continuous
Where you take oestrogen and progesterone every day without a break, causing no monthly bleed. This is usually for postmenopausal women.
2: Sequential
Involves taking oestrogen every day and progesterone for part of the month, resulting in a monthly bleed. This is usually for women who are still getting their periods but are experiencing menopause symptoms.
What symptoms do women experience during menopause?
Common menopause symptoms include:
- anxiety
- mood changes
- skin changes (itchiness, oiliness, and adult acne)
- sleep issues
- pain or discomfort during sex
- hair loss or thinning
- headaches or migraines
- hot flushes
- night sweats
- increased facial hair
- joint aches, pains, and stiffness
- low self-esteem
- heart palpitations
- memory or concentration issues, including brain fog
- recurrent urinary tract infections (UTIs)
- low sex drive
- vaginal dryness and irritation
Other less common symptoms include:
- body shape changes and weight gain
- sensitive teeth or painful gums
- weak bones and increased risk of osteoporosis
- heart disease
Menopause symptoms can last for months or years and can change over time. On average, they last for more than 7 years and 33% of women experience long-term symptoms which can last beyond that.
The reduction in oestrogen being produced by the ovaries can also impact your bone and heart health. Oestrogen is important for maintaining bone strength, so as its levels fall, it can increase the risk of fractures and developing osteoporosis. Low oestrogen levels have also been linked to an increased risk of heart disease in postmenopausal women.
What HRT treatments are available?
Many types of HRT are available and there is not one type of HRT that will suit all women. So, it is important to understand what types of HRT there are, who they are suitable for, what hormones they contain, and which symptoms they are effective for.
Here are some of the common types of HRT:
HRT tablets
Oral combined HRT tablets contain both oestrogen and progesterone and are taken once a day. They work by replacing the hormones that are low during the menopause, like oestrogen.
If you have not had your womb removed you’ll also need to take progesterone to protect your womb lining. This is because oestrogen causes the womb lining to thicken, increasing your risk of womb cancer.
Combined HRT tablets can help relieve most menopause symptoms, including hot flushes, night sweats, brain fog, low mood, and vaginal dryness. They can also prevent osteoporosis and heart disease. Combined HRT tablets are available in continuous and combined regimens.
Continuous combined HRT tablets are usually prescribed if you haven’t had a period for at least 12 months (postmenopausal). Each tablet contains both oestrogen and progesterone and is taken every day.
Continuous combined HRT doesn’t cause a monthly bleed. For example, 94% of women taking Kliofem do not experience bleeding or spotting. Other common examples include:
If you are sensitive to the effects of hormones, a lower dose continuous combined HRT tablet may be more suitable for you, such as:
examples include:Sequential combined HRT tabletsare suitable for women who are still having periods or whose last period was within the last 12 months and who are experiencing menopause symptoms.
With sequential HRT, you’ll take oestrogen every day of your cycle and then a combination of oestrogen and progesterone for 10 to 14 days of each 28-day cycle. You’ll usually have a withdrawal bleed after each course of progesterone.
Alternatively, vaginal tablets , like Vagifem, are a local type of HRT containing oestrogen that are inserted directly into the vagina to relieve vaginal dryness, irritation, and painful sex. Research shows that Vagifem is 85.5% effective at treating these symptoms.
Gina is a type of over-the-counter vaginal HRT tablet that is available in most UK pharmacies and online without a prescription. It can successfully relieve vaginal dryness, itching, and painful sex in as little as 4 weeks.
Tiboloneis another type of HRT tablet that contains the active ingredient, tibolone, which is broken down in the body to produce substances that work similarly to the hormones oestrogen, progesterone, and testosterone. Research shows it is especially effectivefor treating symptoms, like hot flushes, night sweats, and vaginal dryness. Tibolone is taken continuously every day without a break and is suitable for women who have not had a period for at least a year. The exception to this is if you have endometriosis, as tibolone can be prescribed even if you’re pre-menopausal to treat it.
➢ For more guidance on HRT tablets and which may be the best treatment suitable for you, check out our guide
HRT patches
Combined HRT patches like Evorel Conti and Evorel Sequi are an alternative to combined HRT tablets. The patches are applied to the skin and gradually release oestrogen and progesterone into the bloodstream. They are effective for treating hot flushes, mood changes, vaginal irritation, and can prevent osteoporosis.
HRT patches that only contain oestrogen are also available, like Estradot. These may be more suitable if you have had your womb removed or if you would prefer to use them in combination with progesterone tablets, like Utrogestan.
➢ For more information on HRT patches, check out our guide
HRT creams
HRT is also available in cream, gel, and spray form. Examples such as Estriol cream and Ovestincream are applied directly inside the vagina to treat symptoms including vaginal dryness, irritation, and painful sex.
During menopause, a drop in oestrogen causes vaginal atrophy, a condition that causes a thin, dry vaginal wall. Research shows that estriol cream can reduce symptom severity scores by 48%. Because it is a local treatment, it affects the vagina, and has little effect on the rest of the body, meaning it can be used with other HRT methods.
HRT Treatments at a glance
| Name | Form | Active ingredient(s) |
|---|---|---|
| Elleste Duet Conti | Oral tablet |
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| Femoston Conti | Oral tablet |
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| Kliofem | Oral tablet |
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| Premique | Oral tablet |
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| Evorel Conti | Skin patch |
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| Evorel Sequi | Skin patch | Evorel 50: Evorel Conti: |
Where to get HRT treatment
Most HRT treatments require a prescription from a doctor before you can obtain them. You can request HRT online from reputable and trusted online doctor services like Superdrug Online Doctor, pharmacies or from the NHS.
Can you buy HRT treatments online?
Yes, you can request HRT and menopause treatments from Superdrug Online Doctor by:
- Filling out a brief health and lifestyle questionnaire.
- Ordering your preferred treatment and making payment.
- One of our doctors will review your order and questionnaire answers.
- If approved, your treatment will be posted to your address or made available for collection at your local Superdrug Pharmacy.
- If your order is not approved, one of our doctors will contact you via your account with other treatment options.
If you have already been prescribed HRT, you can also request further packs from Superdrug Online Doctor.
Is HRT treatment available over the counter?
Yes, Gina is a type of over-the-counter HRT that can be bought in most UK pharmacies and online without a prescription. It’s a low-dose oestrogen pill that is inserted into the vagina for relief from vaginal dryness, irritation, itching, and pain during sex.
Side effects of HRT medication
Some of the common side effects of HRT medication include:
- headaches
- feeling sick (nausea)
- breast tenderness
- stomach cramps
- vaginal bleeding
- indigestion
- bloating
- leg cramps
- mild skin rash
Not everyone who uses HRT will experience side effects. However, most side effects are mild and can be treated at home by:
- taking over-the-counter painkillers to relieve pain from headaches, breast tenderness, and cramps
- drinking plenty of water to avoid dehydration and help manage symptoms such as headaches and feeling sick
- applying a heat pad to your abdomen if you are experiencing stomach cramps
- taking antacids or indigestion relief as prescribed by your doctor or pharmacist
Most side effects are temporary and improve over time. However, if your symptoms are difficult to manage or have lasted longer than 3 months, you should speak to your doctor for advice.
HRT has also been linked to a small increase in the risk of blood clots and breast cancer. Although the risk is low, you should discuss any family history of these conditions with your doctor before taking HRT. Please see the patient information leaflet that comes with your chosen HRT for further guidance on how to look out for the symptoms of these conditions, who cannot take HRT due to this risk, and when to speak to a doctor.
Who can take HRT?
HRT may not be suitable for everyone. Do not take HRT if you:
- are allergic to any of the ingredients, including oestrogen, progesterone, testosterone, tibolone
- have a history of breast cancer, are currently having tests for breast cancer or are at high risk due to family history
- have ever had ovarian cancer
- have ever had a type of cancer that is sensitive to oestrogen, such as womb (endometrial) cancer or you are having tests for it
- have untreated thickening of the womb lining (endometrial hyperplasia)
- experience unexplained vaginal bleeding
- have ever had a blood clot in a vein (thrombosis) including deep vein thrombosis in your legs or a pulmonary embolism in your lungs
- have blood issues that increase your risk of blood clots
- have ever had liver disease and your liver function tests have not returned to normal
- have recently had a condition caused by blood clots in the arteries, like a heart attack, stroke, or angina
- have a rare genetic condition called porphyria
- are pregnant or breastfeeding
- have high blood pressure
- are diabetic
- have an underactive thyroid
- experience or have ever had migraines or severe headaches
- have lupus
- have epilepsy
- have asthma
- have dementia
- are very obese
Alternatives to HRT
If you cannot take HRT or would prefer not to take it, there are other ways you could manage menopause symptoms, including lifestyle changes, herbal remedies, and other medications.
Lifestyle changes
Some of the lifestyle changes you can make to manage menopause symptoms include:
- getting regular exercise to reduce hot flushes, improve sleep, and mood, and maintain a healthy weight
- following a healthy, balanced diet will help promote bone health, and in combination with exercise, can maintain a healthy weight
- wearing loose clothes and sleeping in a well-ventilated and cool room if you experience hot flushes and night sweats
- reducing your caffeine intake and spicy food consumption because they can trigger hot flushes
- quitting smoking can reduce hot flushes and make menopause symptoms more manageable
- experimenting with vaginal lubricants or moisturisers if you get vaginal dryness – these are easily available over-the-counter
Herbal remedies
Several herbal remedies are reported to help manage menopause symptoms. Despite being readily available on the high street in many health food shops, herbal and complementary remedies are not tested and regulated in the same way as medications. So, it is a good idea to discuss any herbal remedies you are thinking about taking for menopause with your doctor or pharmacist first.
Some of the herbal remedies that can be taken for menopause symptoms are:
- evening primrose oil – may help improve the frequency, severity, and duration of menopause-related hot flushes
- black cohosh – believed to balance hormone levels and relieve numerous menopause symptoms including hot flushes
- angelica – a traditional Chinese herb that contains phytoestrogens, plant-based compounds similar to oestrogen
- ginseng – may help manage hot flushes and improve sexual function
- St John’s wort – a herbal remedy that may be effective for treating hot flushes and night sweats
- red clover – contains phytoestrogens that work similarly to oestrogen
Other medicines
Although HRT is the standard treatment for menopause, it isn’t suitable for everyone. Your doctor may advise a different medication to treat specific symptoms, such as:
- antidepressants for mood-related symptoms
- clonidine to help reduce hot flushes and night sweats
FAQs
What age does the menopause start?
Menopause typically starts between the ages of 45 and 55, but it can occur earlier.
How long does menopause last?
How long menopause lasts is different from person to person, and is influenced by several factors such as age, lifestyle, and genetics. Both menopause and the symptoms of menopause can last from as little as a few months to up to 12 years. The average length is 7 years.
What is premature menopause?
Premature or early menopause is when your periods stop before the age of 45 years. Early menopause is more likely if you start your period before 8 years old, have a family history of premature menopause, have never given birth, or have only given birth once or twice.
What are the risks of HRT?
HRT can increase the risk of some serious health conditions, such as breast cancer, blood clots, strokes, and heart attacks. The risk of serious side effects caused by HRT is usually very low and will depend on the type you take, how long you take it for, and your medical history. Your doctor will discuss the risks of HRT with you during your consultation.
How long do I need to take HRT for?
You will need to use HRT for as long as it is required, usually between 2 and 5 years. Your doctor will review your medication every year to see if it is still working for you.
What are the signs that HRT is working?
You’ll usually know that HRT is working by the relief or reduction in the severity of your menopause symptoms. It can take up to 3 months for HRT to work fully.
Does HRT cause weight gain?
Although some women do put weight on while using HRT, there is no evidence to suggest that it is the HRT itself causing it. Weight fluctuations during menopause are common, due to hormonal changes, even if you are not taking HRT.
How do I know if I need a higher dose of HRT?
If you have been taking HRT for 3 months and your symptoms have not improved, you may need a higher dose or a different type of HRT. If you feel that your current dose isn’t working for you, speak to your doctor.
How long does HRT take to work?
HRT can take up to 3 months to work, but some people may notice benefits within a few weeks of starting treatment.
Does HRT stop periods?
Yes, HRT can stop periods temporarily or permanently, but not every woman will experience this. Once you have reached postmenopause, you will no longer have periods, even if you have not used HRT.
Sources
- About sequential combined hormone replacement therapy (HRT), NHS [accessed 06 February 2025]
- Alternatives to hormone replacement therapy (HRT), NHS [accessed 07 February 2025]
- Beneficial effect of tibolone on mood, cognition, well-being, and sexuality in menopausal women, PubMed [accessed 28 January 2025]
- Effect of St John's wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal and postmenopausal women: a randomized, double-blind, placebo-controlled study, PubMed [accessed 07 February 2025]
- Efficacy and safety of ultra-low-dose Vagifem (10 mcg), PubMed [accessed 06 February 2025]
- Gina 10 micrograms vaginal tablets, emc [accessed 06 February 2025]
- Kliofem 2 mg/1 mg film-coated tablets, emc [accessed 06 February 2025]
- Menopause, NHS [accessed 06 February 2025]
- Menopause, WHO [accessed 06 February 2025]
- Menopause Predisposes Women to Increased Risk of Cardiovascular Disease, PubMed [accessed 06 February 2025]
- The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial, PubMed [accessed 07 February 2025]
- Vaginal hormone-free moisturising cream is not inferior to an estriol cream for treating symptoms of vulvovaginal atrophy: Prospective, randomised study, PubMed [accessed 06 February 2025]
- Menopause, NHS inform [accessed 06 February 2025]
- Who can and cannot take continuous combined HRT, NHS [accessed 07 February 2025]
- Peri-menopause and menopause: Signs and symptoms, Cambridge University Hospitals NHS [accessed 07 February 2025]
- Menopause, Pubmed [accessed 07 February 2025]
Medically reviewed by
Dr. IkejiLast reviewed: 12 Mar 2025
