According to the NHS, more than 1 million women in the UK use hormone replacement therapy (known as HRT) to relieve menopausal symptoms, from hot flushes to vaginal dryness. Recently, there has been a huge increase in demand and media attention around the wonder drug, leading to supply issues and shortages. So what is HRT and how does it work? We've put together the answers to all your questions below.
Hormone replacement therapy is a treatment to relieve symptoms of the menopause. As you approach the menopause, some hormone levels (particularly estrogen) lower, causing symtpoms such as hot flushes, night sweats, mood swings, vaginal dryness and reduced sex drive. Most of these symptoms naturally pass after a few years, however, taking HRT can speed up the process by replacing the hormones, in turn reducing or even completely eliminating the symptoms.
HRT focuses on replacing the estrogen that your body no longer makes leading up to, and after menopause. There are two main types of therapy that used:
For hormone replacement therapy to work effectively, your hormones must be balanced. Because of this, doctors usually prescribe progesterone medication alongside HRT. This is because increasing your oestrogen levels alone, when not balanced by progesterone, can stimulate growth of the lining of the uterus, increasing the risk of endometrial cancer. However, if you have had your uterus removed (hysterectomy), you might not need to take progestin.
The benefits of HRT are generally believed to outweigh the risks. However, some types of HRT have been linked to an increase in breast cancer, heart disease, stroke, or blood clots. The risks are usually small, and depend on the type of HRT you take, how long you take it, and your health background.
Studies have suggested the increased risk of developing certain illnesses depends on:
If you're thinking about taking HRT or are already taking it and have any worries about the risks associated with it, be sure to speak with your GP.
If you think HRT might work for you, you'll need to speak with your GP first. They will run through your symptoms and a background check to see if you are eligible, and they will also explain the different types of HRT available and answer any questions you might have.
You can usually begin HRT as soon as you start experiencing menopausal symptoms, and there are no tests required.
Your doctor usually recommends starting on a low dose, which may be increased later. Typically, you will start on a trial period of three months to see if it helps. If after three months, you notice no improvements, they may change your dose or suggest another alternative type of HRT medication.
Most women can take HRT if they are experiencing menopausal symptoms. However, HRT may not be suitable for you if you:
If any of the above apply to you, you should still discuss this with your doctor as other alternatives will be recommended instead.
As with any medication, you may experience side effects, however, these will usually pass within three months of starting treatment.
Some common side effects include:
If you experience any side effects when taking HRT, you should discuss this with your GP.
Hormone replacement therapy isn't right for everyone and there are alternative ways to manage menopausal symptoms.
Recently, there has been a shortage of hormone therapy replacement gels and patches in the UK, which has been widely discussed and debated in the media, by the likes of Davina McCall.
According to the Department of Health, the HRT shortage is due to a rise in demand, which is fuelled by greater awareness of menopause and more confidence among GPs prescribing the medication. The DH has stated they are currently working to resolve the shortage and limit supplies to three months per person to even out distribution.
