Hormone replacement therapy (HRT): what it means
Hormone replacement therapy (HRT) is treatment that replaces the estrogen the ovaries stop making around menopause, usually with a progestogen as well to protect the uterine lining. It eases hot flashes, night sweats, vaginal dryness, sleep and mood problems, and protects bone. It comes as tablets, patches, gels or sprays, and suits many people under 60.
Types of HRT
| Type | Who it is for |
|---|---|
| Estrogen only | people who have had their uterus removed |
| Combined estrogen + progestogen | people with a uterus, to prevent overgrowth of the lining |
| Cyclical (sequential) | perimenopause: a monthly bleed |
| Continuous combined | after periods have stopped for a year: usually no bleed |
| Vaginal estrogen | dryness and urinary symptoms; very low dose, local |
A hormonal IUD can provide the progestogen part. Testosterone is sometimes added for persistent low desire.
Benefits and risks
For most people under 60 or within 10 years of menopause, the NHS and NICE say benefits generally outweigh risks. Patches and gels do not raise blood clot risk the way tablets can. Combined HRT slightly increases breast cancer risk with longer use; your doctor can put the numbers in context for you.
HRT and mood
Perimenopause can bring anxiety, irritability, low mood and brain fog, sometimes before periods change much. HRT often helps these, along with sleep. For low mood that persists, talking therapy or antidepressants may also be offered. Tracking mood alongside symptoms makes the conversation with a doctor easier. See perimenopause mood swings.
See a doctor before starting HRT, and again if you have unexpected bleeding after the first 3 to 6 months, bleeding after periods have stopped, a new breast lump, or a painful swollen leg.
Frequently asked questions
Can I take HRT while still having periods?
Yes. Cyclical HRT is designed for perimenopause, when periods are still coming.
How long can I take HRT?
There is no fixed limit. It is reviewed at least yearly, balancing your symptoms against your individual risks.
Sources
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
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