There are many benefits to taking HRT. However, it is important to learn about both the risks and benefits of HRT so that you can properly assess your risk-to-benefit ratio.
The decision to take HRT isn't always an easy one - don't rush yourself into a decision. You must be fully aware of all options available to you. There are, however, many benefits to choosing HRT. These are often overlooked when assessing your personal risks and benefits.
When it comes to HRT, you have options:
You are not limited by your choices when considering starting HRT. There are several different types, and you can choose one that you feel comfortable with. Your options, however, will depend on whether you still have a womb (uterus) or if you have had a hysterectomy (womb removed). If you still have a womb, you will need combined HRT, consisting of estrogen and progesterone.
You can then decide between full systemic (whole-body) benefits - in which case you can choose from patches, sprays or gels. Or, if you are just looking to resolve symptoms that are vaginal or urinary, then you can select local vaginal oestrogen treatments. Vaginal oestrogen can also be safely used in combination with full systemic HRT if you are struggling with both full body and vaginal symptoms.
Here is a summary of the different types available to you:
- Oestrogen HRT - Oestrogen-only HRT can be taken by women who have had a hysterectomy (no longer have a womb). They will not require progesterone alongside estrogen.
- Combined HRT - Oestrogen + Progesterone HRT. This is the most common type of HRT, and is for women who still have their womb.
- Vaginal HRT - Works locally in the vaginal area, targeted for urogenital symptoms.
There are also many different forms of HRT you can take, including:
- Less commonly: Implants
As you can see, depending on symptom severity and your overall comfort with HRT, you can choose the treatment that best suits you. You can also change your mind if one form of HRT is not working well - you have options.
At Bia, we only recommend transdermal HRT (patches, gels or sprays, with body-identical progesterone) and vaginal oestrogen. This is because these are very safe and low risk for women. If you have questions about the options through Bia, please get in touch.
It's essential to have your treatment reviewed after 3 months, and then yearly to ensure that you are getting the full benefits from your medication.
Full (systemic) HRT reduces the symptoms of menopause
The most significant benefit of HRT is that it can help women with their symptoms. It is the most effective way to reduce many menopausal symptoms, including:
- Hot flushes and night sweats. It may even reduce hot flush severity by 78%.
- Mood swings, anxiety, sleep problem and brain fog. Our assessment data reported that difficulty sleeping and anxiety were amongst the most frequently experienced symptoms in menopausal women.
- Low sex drive (low libido). This is a common severe symptom that is often under-discussed.
- Dry skin and brittle/thin hair. Women may notice improvement in their skin and hair.
- Migraines. HRT may help control migraines, but this is a tricky area - in some women, HRT may reduce the number of migraine attacks, but in others, they may worsen. It is worth having a detailed discussion with one of Bia's doctors about this. Women with migraines are usually recommended to use oestrogen patches, rather than tablets.
Vaginal oestrogen reduces vaginal and urinary symptoms of menopause
Vaginal oestrogen can help with vaginal dryness and may help make sex more comfortable. It can also help with other urogenital symptoms, such as the need to pass urine frequently, recurrent urinary tract infections, and menopause-related urinary incontinence.
This is the lowest risk HRT because it is a very low dose, and only works in the local area. Vaginal oestrogen can be used alone without the addition of progesterone, as none of the hormones are absorbed into the bloodstream. This is useful if you are sensitive to progesterone side effects.
Benefits of HRT on women's long term health
1. HRT and Cardiovascular Health
- The highest quality research (Cochrane Systematic reviews) have demonstrated that HRT started under the age of 60 years, may protect women from the risk of developing cardiovascular disease such as a heart attack - However, it is worth noting that starting HRT over the age of 60 years might slightly increase the risk of cardiovascular disease.
- So, if you are thinking about taking HRT it is worth starting when your menopause symptoms begin to trouble you, rather than waiting.
2. HRT and bone health (including osteoporosis)
- As a menopausal woman, you are significantly more likely to have an osteoporotic fracture. This is because your bones may get thinner and begin to weaken as a result of your estrogen levels decreasing.
- HRT has a strong protective effect on bones and muscles by helping to maintain your bone mineral density and reducing the risk of osteoporosis or osteopenia. The longer you have taken HRT, the longer the benefits last.
3. HRT and muscle strength
- Like menopause and your bones, as a menopausal woman, you are at a higher risk of losing muscle mass.
- There is evidence that HRT can help you maintain your muscle strength during this transition.
- However, it is also important to ensure you exercise regularly and do not rely solely on HRT.
4. HRT and diabetes
- Taking HRT will not increase your risk of developing type 2 diabetes.
- If you already have type 2 diabetes and want to take HRT, you can - HRT is unlikely to have any adverse effects on your blood sugar / your bodies ability to control your blood sugar.
- You should still consult with your GP prior to beginning HRT, just to ensure you account for any health problems that may be related to you diabetes.
5. HRT and brain health
- There is also some evidence that HRT may reduce the risk of developing dementia, though more research is needed.
Every person's response to HRT is different. It's hard to know if it's a good option for you without trying it. Often, women are more focused on the risks of HRT and will overlook the benefits on long-term health. It is important that you familiarise yourself with both. Only then can you make a fully informed decision moving forward.