Hormone replacement therapy can be used by women who still have periods. They just need to do it differently and this is known as cyclical HRT. This article will explain what cyclical HRT means and why it's important.
Recap: What is hormone replacement therapy (HRT), and how does it work?
HRT refers to when your body takes a medication to replace its natural hormones. This happens because estrogen and progesterone, the main female hormones, drop in perimenopause as well as menopause.
HRT can contain some form of estrogen. You will receive estrogen alone if you have had a previous hysterectomy. Otherwise, estrogen will be mixed with a progestogen. Your risk factors, preferences, symptoms, and whether you have still been having periods will all influence the type of HRT you choose. You can read our Hormone Replacement Therapy article for a better overview.
What is cyclical (HRT), and what are its implications?
There is a common misconception that HRT can't be used if you are still experiencing periods. This is false. You can take HRT if you're still having your periods. Perimenopause is when your periods end and your hormones swing from high to low. This is often when women feel their worst symptoms and HRT might be a good option.
Are there different types of cyclical HRT available?
There are generally two types of cyclical HRT.
- Monthly cyclical HRT. This is when you take estrogen every single day and progesterone during the last 14 days. This option is for women who have regular periods but are experiencing symptoms of menopause.
- Three monthly cycles of HRT. This is where you take estrogen daily and progestogen (if necessary) for approximately 14 days each 3 months. This is for women with irregular periods.
Are there any periods with cyclical HRT that I will have to use?
Yes. If you are taking monthly cyclical HRT you should roughly have a bleed each month. If you are taking three monthly cyclical HRT, you should have a bleed every 3 months.
How does HRT need change as we age?
Your HRT requirements will change as your hormone levels drop and you move through menopause (one-year without periods). The transition from taking hormones only cyclically to continuous HRT will occur. Continuous HRT is the practice of taking estrogen (and progestogen, if you have one) daily without any breaks.
This will usually happen after 2-5 year of cyclical HRT or when you reach the age 54.