Hormone replacement therapy (HRT) is a way of treating the symptoms of menopause by taking hormone medication. The benefits of HRT don't stop with symptom relief though.
Deciding to start HRT might not be easy. If you're not sure why you should consider starting then it helps to understand the benefits. There are reasons why HRT can be a better choice than 'natural' treatment, or no treatment.
Systemic HRT (HRT that affects your whole body) protects you from a very serious health risk – these HRTs has a very significant effect on bone health to dramatically reduce the risk of osteoporosis and osteoporotic fracture. This is because they:
Fracturing a major site such as your hip is linked to a 20% increased risk of dying. For those who survive, they often lose their independence and report a lower quality of life.
Systemic HRT may reduce the risk of heart disease and stroke too:
Systemic HRT may also reduce the risk of:
As well as health risks, HRT can also improve the symptoms of menopause (the number of symptoms improved will depend on the type of HRT). These include:
HRT needs is most helpful when taken at the right time in your life – for the most part, these benefits are seen in women who use HRT through the menopausal transition, and this time period is called “the window of opportunity.” This means women taking HRT in their 50’s-60’s. This is because, if they do not take HRT through the window of opportunity, the disease precursors may develop, and by the time take HRT later in life, it may be too late for HRT to have any influence or be more risky to use.
Please note – some benefits that occur while taking HRT are lost when HRT is discontinued.
HRT compared to menopause without treatment:
A ‘natural menopause’ is a loss of hormone levels – oestrogen production is an essential part of a healthy woman’s body. During menopause, oestrogen levels drop, and this has longer term negative consequences for your health. HRT helps protect you from this.
"Why ‘medicalise’ a natural process women go through?" – the need to ‘medicalise’ menopause comes from the increased health risks associated with it and the fact that not treating them leads to lower life expectancy and quality of life.
Support for ‘natural menopause’ is based on false information – two studies done in the 1990s that mistaken suggested HRT was causing a risk in cancer and heart disease caused widespread panic that resulted in huge numbers of women missing out on HRT treatment. See here for more information.
Combined HRT has the most possible benefits – this is because it involves treatment with progesterone and oestrogen so you may experience additional benefits alongside your menopause treatment. This can be in the form of:
What extra benefits can combined HRT cause? – progesterone and oestrogen combined treatment can help:
Vaginal HRT is the safest – there is less chance of side effects here because it only affects your vagina and not your whole body like patches or oral tablets. It also doesn’t need to include progesterone because it doesn’t affect the womb.
Vaginal HRT also improve vaginal dryness the most – because it’s applied directly to the vagina it can cause the most improvement for this symptom.
Continuous HRT will mean no menstrual bleeding – compared to cyclical HRT, where you have bleeding breaks, continuous HRT means you don’t have to regularly stop and have a menstrual bleed. Not everyone can have continuous HRT though, you must:
Yes, when it comes to relieving the main symptoms of menopause – Many HRTs have been shown to be the most effective way of relieving hot flushes and night sweats. In a 2004 Cochrane review, oral HRT reduced hot flushes by 75% compared to a placebo. This is a superior response to any other currently available menopausal treatment.
How do I decide on a menopause treatment? – an assessment from a doctor will help you figure out which menopause treatment is right for you. They will assess you on the following:
For systemic HRT – you should initially be assessed for HRT via a face to face appointment (usually with your GP or gynaecologist). Then a follow up consultation should also be arranged to check your progress with the treatment. Once established on treatment you can fill in a short health questionnaire using our online service and reorder your treatment.
For vaginal-only HRT – you can get assessed for starting your first treatment with us by filling in a short health questionnaire.
For all treatments – your online doctor will check your assessment and approve treatment if it’s appropriate for you.
Can I use herbal supplements instead? – buying alternative herbal products/dietary supplements may have no benefits and some potential risks:
HRT does come with a risk of side effects – common side effects include:
Is HRT right for everyone? – no, HRT treatment is not right for everyone. You may not have HRT if:
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Welton, A. J. et al (2008). Health related quality of life after combined hormone replacement therapy: randomised controlled trial. BMJ, Aug; 337: a1190.