The Basics of Hormone Replacement Therapy Explained

The Basics of Hormone Replacement Therapy Explained

What is HRT and what does it do?

During menopause, women experience a decline in hormone levels and Menopausal symptoms are caused by this decline. Specifically, these hormone deficiencies happen because your ovaries are stopping ovulation and with it the production of oestrogen and progesterone.

Hormone replacement therapy, or HRT, restores the low levels of oestrogen in the body and relieves symptoms. HRT typically consists of oestrogen and a progestogen, though sometimes testosterone can also be taken. These can be taken as a pill, patch, gel or vaginally. According to scientific research, HRT is the most effective way of providing relief for menopausal symptoms.  


All oestrogens used for HRT are natural - usually sourced from plants such as yams or soybeans. Historically, oestrogens were derived from horses' urine, but these drugs such as Premarin, are very rarely prescribed today! You can read about what oestrogen does in the body here.


Progesterone’s role in the body is described in this article here. When given as part of HRT, progesterone protects the womb from overactivity by the oestrogen that is being taken. This is important because overactivity can lead to thickening of the womb, also known as hyperplasia, and can develop into cancer. The progesterone component of HRT is essential in women who still have a uterus and are taking systemic HRT.
Curious about the difference between systemic and local HRT? Take a look at this article.

What are the different types of HRT?

HRT falls into two categories: systemic or localised. Systemic HRT refers to regimes where the hormones are absorbed into your blood stream, whereas localised HRT’s effects remain concentrated to a local area, usually the vagina. Some examples of each are listed below:

There are several differences between systemic and localised HRT which you can read about here. The primary difference being that with localised HRT, you’re not required to take progesterone, since hardly any oestrogen is absorbed into the body.

Are there side effects with HRT?

Getting the correct dose and type of HRT can take a while for some women – up to year in a few cases – but this shouldn’t discourage you as HRT has great benefits on your wellbeing and long-term health. Fortunately, with the wide range of HRTs available, there will be a regime that works for you. In this section we want to talk about some side-effects of HRT so you can let you doctor know, who can adjust your HRT accordingly. 

Side effects:

Many of the side-effects of HRT can occur as a result of sudden replacement of oestrogen after long periods of low oestrogen in the body. Some women report bloating, indigestion, breast pain, nausea or headaches. However, we want to reassure you these are often temporary and go away within a couple months.

If these side-effects last longer than 3 months, ask your doctor to review and change your HRT regime or dose to see if this helps. If you notice increasingly negative changes to your mood or acne, this may be the progesterone part of your HRT, which can also be adjusted by your doctor. It is essential you keep taking HRT as prescribed. Stopping or reducing doses of your medication, especially the progesterone, can have dangerous effects. Always make sure to talk to your doctor first.

If you still have questions about HRT or are confused about something, feel free to contact us and we’ll be happy to answer any questions.


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