FAQs before starting HRT

There are many questions that you might have before starting HRT. Here are the answers to some of the most frequently asked questions.

What are the advantages of HRT?

HRT is the best solution for many symptoms including hot flushes, hormonal mood changes, low libido, vaginal dryness and urinary symptoms.

HRT has strong protection effects on bones and muscles, which reduces the chance of developing osteoporosis.

If started before the age of 60, it may help protect women from a heart attack. It may also reduce the risk of developing dementia. However, more research is required.

What is the average time it takes for HRT to take effect?

It takes approximately 3 months to stabilise your hormones. Some symptoms such as flushes, may improve within two weeks.

What is body identical HRT?

Body identical HRT has the exact same chemical structure as your body's own hormones. The chemical structure of body identical progesterone, such as micro-ionised progesterone, is the same as that of human progesterone. Yams are the source of both body-identical estrogen and progesterone.

Micro-ionized progesterone may have fewer side effects and be less likely to cause breast cancer than other types of progesterone.

Body identical hormones are regulated and used by the NHS and menopause specialists. They should not be confused with bio-identical hormones that are sold by private clinics and are not approved or regulated. These products are not recommended by the British Menopause Society.

Are there side effects?

Side effects of hormones include nausea, breast tenderness and leg cramps. Side effects usually disappear within 3 to 6 months.

Patches can cause skin irritation, if so it is possible to switch to a gel or change the type of patch.

In the first few weeks, some women experience mild swelling and bloating due to fluid retention. However, this should resolve quickly.

You can read more about the side effects of HRT here.

What are the potential risks of HRT

Your personal medical history and the HRT you use will have an impact on the risks.

HRT tablets have a slightly higher risk of developing blood clots than patches or gels.

HRTTablets can also slightly increase stroke risk. Women under 60 years old are at very low risk of suffering a stroke. The risk of stroke is not increased by HRT patches and gels.


Is HRT a cause of breast cancer?

HRT comes in many forms. The type of HRT you choose will depend on whether or not you have a womb and if you are still having periods.

After a hysterectomy (where your womb was removed), you will be prescribed estrogen-only HRT. This is associated with a lower risk of developing breast cancer.

Ifyou have a womb, you will need combined HRT that contains both estrogens and progesterone. Although this is associated with a higher risk of breast cancer development, it does not increase your risk of dying from the disease. The length of the HRT you use will determine how high your risk. Once it has been stopped, it will decrease.

Progesterone type in HRT can affect breast cancer risk. Utrogestan (micronized progesterone)is the most safe type.

Other factors than HRT are also associated with breast cancer risk, such as obesity and alcohol consumption.

What length of time do I have to take HRT?

This is an individual decision, but HRT should be reviewed at least every five years. Your HRT should be reviewed once you turn 60 years old. As you age, the balance between risks and benefits changes. Many women, but not all stop taking HRT at 60. There is no age limit for HRT.

Can HRT be used to stop my periods

No. HRTis prescribed to complement your current cycle and replace natural hormones. You should not take HRT at a lower dose than the combined contraceptive pill or hormones used for stopping your periods.

Will HRT improve low mood?

HRT can help with anxiety or low moods due to hormonal changes. However, if you are still experiencing anxiety or depression after the menopause, it is important to talk to your doctor. Anxiety and depression may not be related to hormone changes.

Is HRT a good way to lose weight?

Although there isn't any evidence that HRT can help you lose weight it may help you to feel more positive about your body.

Is HRT a contraceptive?

No. HRT is not contraceptive. However, some women may still need contraception if they are taking HRT.

UK The faculty of sexual and reproduction healthcare suggests that all women should be able to stop using contraception after age 55.

Women aged 40-50 can stop using contraception if they have not had periods in the past 2 years. If you have not had periods in the past year, women over 50 years old can discontinue contraception. This assumes your periods stopped because of the menopause and not medical treatment like a Mirena IUS. Talk to your doctor about when you can stop using contraception.


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