Hormone Replacement Therapy (HRT)

The symptoms of menopause can be unpleasant, and can include:

• hot flushes
• night sweats
• mood swings
• sleeping difficulties
• reduced sex drive

Severe menopausal symptoms can interfere with everyday life. If your symptoms are having a significant impact on your day to day activity you may want to seek treatment to alleviate your symptoms.

Hormone replacement therapy, as the name suggests, replaces some of the hormones that are at a lower level when you reach menopause.

Most women take a combination of oestrogen and progesterone hormones, but if you do not have a womb then you can take oestrogen on its own. The aim of HRT is to supply you with the hormones that stop being produced during menopause.

The two main types of HRT are oestrogen-only HRT and combined HRT.

Oestrogen-only HRT is mostly used by women who have had their womb removed since they don’t need progestogen, a hormone that protects the lining of the womb.

For cases of vaginal HRT it can be used by women with a womb, and they don’t need the progestogen because it is applied locally to the vagina only.

Combined HRT involves a combination of oestrogen and progestogen. It’s typically used in one of 2 ways:

• Continuous combined HRT - involves taking the hormones together once a day for 28 days continuously. It doesn’t include a withdrawal bleed and is usually for women who have already stopped having periods.
• Sequential combined HRT - involves taking oestrogen for 14 days, then both hormones for 14 more days, resulting in a monthly withdrawal bleed and is usually for women who still have periods.

Using our service you can get a new prescription or a repeat prescription for HRT medication. Once your order and payment has been processed, our doctors will review your questionnaire and, if approved, send you your prescription.

Using Superdrug Online Doctor you can get a prescription for the following HRT medications: Vagifem, Ovestin, Blissel, Evorel Conti, Estradot, Provera, Femoston-Conti, Kilogest, Activelle, Tibolone.

There are different types of HRT you’ll be able to choose from, initially with the help of your GP. There are:

• Combined HRT tablets - one of the most common ways to take HRT, they contain both oestrogen and progestogen. There are many different tablets available. They are especially effective at treating the short-term side effects of the menopause. Long-term complications of menopause, such as osteoporosis can also be treated using this type of HRT.
• Combined HRT patches - These are applied once or twice a week on any area below the waist. They are as effective as tablets at treating the short and long term side effects of menopause.
• Vaginal oestrogen - Also known as ‘local HRT’, they can come in several forms, including creams, tablets, rings, and pessaries.

All of these contain a small amount of oestrogen and are used to treat the specific symptoms where they are applied, such as vaginal dryness and urinary symptoms.

Local HRT will not help with symptoms such as hot flushes or with long-term symptoms such as osteoporosis. However, they can be used by both women as they don’t have the same increased risks.

In many cases, the advantages of HRT outweigh the disadvantages. You can talk through any concerns you have with your GP. They will be able to advise you on the different types and forms of HRT. A low dosage will probably be recommended at first and may be increased if that dosage doesn’t help with your symptoms.

HRT is the most effective way to treat menopausal symptoms. Particularly hot flushes. It can also reduce the risk of fractures, improve vaginal dryness, sleep patterns, increase sex drive, and improve aches and pains.

However, there are some downsides, as some studies confirm the increased risk of cancer and cardiovascular disease.

It is recommended that you consider the downsides alongside the benefits of HRT in order to establish what treatment is best for you. Women who are already at an increased risk of cancer will usually be advised against taking HRT.

Side effects are possible when taking HRT. These effects may last a few months, though people may react differently to HRT.

The common side effects of HRT include:

• Headaches
• Nausea
• Breast tenderness
• Stomach pain
• Indigestion
• Vaginal bleeding
• A small increase in the risk of blood clots and breast cancer

HRT may also increase the risk of other medical conditions:

Endometrial cancer - women who have not had a hysterectomy and are postmenopausal are at an increased risk of endometrial cancer if they take oestrogen-only HRT.

Ovarian cancer - women taking HRT are also at a slightly increased risk of ovarian cancer.

Blood clots – HRT tablets, but not patches or gels, have been linked to an increased risk of developing blood clots.

Breast cancer – studies have shown that oestrogen-only HRT causes little or no increased risk of breast cancer. However, combination HRT may increase the risk of breast cancer, but if you stop taking HRT then your risk will reduce again.

If you or someone you know is experiencing side effects, or there is an emergency, for example, breathing problems or chest pain you should seek medical attention immediately.