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Hormone Replacement Therapy (HRT)
Hormone replacement therapy is when oestrogen is taken to replace declining oestrogen levels caused by menopause. Not all women choose to take HRT to treat their menopausal symptoms. However, those who find symptoms particularly hard to deal with can find that taking oestrogen or a combination of oestrogen and progesterone can be very effective in relieving menopausal signs.

Hormone Replacement Therapy (HRT)

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  1. Buy Livial (Tibolone) HRT Medication from UK online pharmacy Medicine Direct
    Livial (Tibolone) 2.5mg
    From As low as £49.99
    • Contains Tibolone as the active ingredient
    • Hormone Replacement Therapy (HRT)
    • Relieves symptoms of the menopause
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  2. Premique
    Premique
    From As low as £24.99
    • Used to treat post-menopausal women
    • Take one tablet daily
    • Modified release tablets
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  3. Kliovance
    Kliovance
    • Kliovance replaces the lost hormones caused by Menopause
    • Contains 2 active ingredients, Estradiol and Norethisterone
    • Used to prevent Osteoporosis
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  4. Evorel Conti Patch
    Evorel Conti Patch
    • Relieve Menopause symptoms and prevent Osteoporosis
    • The patches release lost hormones caused by Menopause back into the body
    • Can treat, night sweats, sleep disturbance, anxiety, depression, sexual dysfunction and hot flushes
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  5. Estriol Cream
    Estriol Cream
    From As low as £49.99
    • Helps to treat the vaginal symptoms of menopause
    • Cream must be applied daily for full benefits
    • Comes with applicator for ease of use
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  6. Zumenon
    Zumenon
    From As low as £23.99
    • Helps to relieve the symptoms of Menopause
    • Replenishes the natural levels of Oestrogen
    • Available in tablet form
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  7. Premarin
    Premarin
    • Replaces the bodys natural level of Oestrogen
    • Relieves the symptoms of Menopause
    • Protects against Osteoporosis
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  8. Femoston
    Femoston
    From As low as £38.99
    • Widely prescribed for the treatment of Menopause
    • Used to prevent Osteoporosis
    • Noticeable benefits in just a few weeks
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  9. Evorel Sequi
    Evorel Sequi
    • Patches release naturally occurring hormones back into the body
    • Help to supress the signs and symptoms of Menopause
    • Reduces the likelihood of developing Osteoporosis
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  10. Evorel
    Evorel
    • Used in the early signs of femaly menopause
    • Provides a continuous release of Oestrogen into the body
    • HTH Patches to reduce the signs and symptoms of menopause
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  11. Estradot
    Estradot
    From As low as £22.99
    • Highly effective HRT patches
    • Replenishes the bodys natural hormones lost by menopause
    • Helps with symptoms caused by menopause
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  12. Elleste Solo MX
    Elleste Solo MX
    From As low as £29.99
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  13. Elleste Duet
    Elleste Duet
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  14. Elleste Solo
    Elleste Solo
    From As low as £19.99
    • Relieves a range of symptoms associated with the menopause
    • Replenishes the body with Oestrogen lost due to the menopause
    • Helps to prevent Oseoporosis
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Overview

What is Hormone Replacement Therapy (HRT)?

Menopause is a natural part of the ageing process and is commonly referred to as 'the change'. Many women go through menopause between the ages of 45 and 55. It is when your periods begin to lessen or stop completely, and you can no longer naturally become pregnant.

‘The change’ happens when a woman’s hormones reduce as your ovaries stop producing as much oestrogen. Other factors which can cause menopause to begin include chemotherapy, the removal of the ovaries during surgery or some treatments for breast cancer.

Some women can experience premature menopause, which is when your period stops before the age of 45.

Symptoms

Symptoms of Menopause

The most common signs of menopause are:

  • Low mood, mood swings, anxiety or depression
  • Vaginal dryness
  • Hot flushes and night sweats
  • Reduced libido
  • Memory loss

Menopausal symptoms are caused by a natural reduction in hormones. Your ovaries begin to produce less oestrogen and progesterone the older you become. Generally, by your mid-40s your periods will have become either longer or shorter, and by your 50s stop completely. This is due to your ovaries beginning to reduce the production of eggs.

Causes

What Causes Menopause

Menopause is a natural part of the aging process. Many women go through menopause between the ages of 45 and 55. It is when your periods begin to lessen or stop completely, and you can no longer naturally become pregnant.

‘The change’, happens when women’s hormones reduce as your ovaries stop producing as much oestrogen. Other factors which can cause menopause to begin include chemotherapy, the removal of the ovaries in surgery or some treatments for breast cancer.

Some women can experience premature menopause, which is when your period stops before the age of 45.

Diagnosis

Diagnosis of Menopause

When should a doctor be contacted?

Many women prefer to go and see their doctor for advice when they notice the first signs of menopause. Your doctor will be able to confirm whether you are going though menopause by discussing your symptoms and taking a blood test. The blood sample will show them your hormone levels.

If you are concerned you may be going through premature menopause, your doctor will be able to make a diagnosis according to your family history and from the results of your blood tests. Being told you are going through premature menopause can be upsetting for women as it can affect their ability to naturally have children. There are a range of support groups women can turn to for advice and help such as The Daisy Network, which is for women who are experiencing premature ovarian failure.

Treatment

What Are The Different Types of HRT Available

What are the different types of HRT available?

There are two forms of hormone replacement therapies available: combined HRT or oestrogen-only hormone replacement therapy. Combined HRT treatments such as Kliovance, Premique, Evorel, Elleste Duet and Femoston are more commonly prescribed, as you can only take oestrogen-only if you have had your womb removed. This is due to a link between oestrogen and womb cancer. Popular oestrogen-only options are Elleste Solo, Premarin and Zumenon.

Is HRT the right choice for me?

HRT patches can also provide effective relief from symptoms and are safe and easy to use. Evorel Conti HRT Patches, Evorel, Estradot, Elleste Solo MX and Evorel Sequi are commonly prescribed HRT patches.

Both forms of hormone replacement can come in the form of skin patches such as Estradot, tablets, gel or implants. You will be prescribed the lowest effective dose possible. HRT treatment is safe to use until your symptoms become easier to handle.

A doctor will be able to help you decided which form of HRT is most suitable for you. Usually, the treatment will take a few weeks to produce any results. That is why a doctor will recommend that you continue using the HRT for up to three months, to allow it time to work.

How can I get HRT?

Our UK based pharmacy stocks a variety of hormone replacement treatments. Simply fill in an online consultation with one of our qualified pharmacists, and they will prescribe the most appropriate hormone replacement therapy treatment for your needs.

FAQs

At what age does menopause start?


The menopause occurs in different women at different ages, although the average age for British women is 51 years old. The normal age ranges between 45 and 55 years old. A woman's oestrogen levels gradually start to decline during their 30s, so it is common to experience symptoms of menopause while still having periods.

What is premature menopause?


Premature menopause is also known as premature ovary insufficiency; it happens when a woman experiences the menopause before she turns 40. This is rare and only happens in around 1% of all women.

What are the symptoms of menopause?


The key symptoms are:

  • Low mood, anxiety or depression
  • Vaginal dryness
  • Hot flushes and night sweats
  • Reduced libido
  • Difficulty remembering

For how long do these symptoms last?


How long symptoms last depend on the individual; sometimes, they can start years before the menopause and remain for years. On average, symptoms last for around four years, although around 10% of women will have symptoms for much longer, sometimes for up to 12 years.

What are the risks of HRT?


According to the National Institute for Health and Care Excellence guidelines, the risks of hormone replacement therapy are small. However, it is recommended to always understand the risk of a treatment before beginning it.

Combined oestrogen and progesterone HRT is associated with a risk of breast cancer. It is estimated that the risk of breast cancer is reduced back to normal after 5 years of finishing treatment. Combined hormone replacement is also associated with a very small risk of heart disease. Oestrogen-only HRT is thought to increase the risk of womb cancer.

The link between womb cancer and oestrogen HRT is why women with ovaries are not given oestrogen-only treatment. Instead, you will be most likely prescribed the combined HRT pill. Both forms of hormone replacement tablets can increase your rise of blood clots. HRT patches or gels, however, do not have this associated risk. The evidence of these small risks has made some doctors reluctant to prescribe HRT.

Nonetheless, the national health institute says that the benefits of HRT treatment outweighs the minimal risk. Speak to your doctor if you are concerned about any of them possibilities outlined above.

What are hot flushes?


Hot flushes affect 75% of menopausal women, making it the most common symptom. A hot flush is when a woman feels spontaneous heat spreading around her body. You may also notice sweating and a strong heartbeat; the skin blushing red also occurs in some women. They are likely caused by irregularities in your body temperature as a result of hormone changes. The severity of hot flushes varies in severity; some women only experience them every so often, making it a mild irritant, while others may have up to 20 hot flushes each day.

What treatments are available for the symptoms of menopause?


During hormone replacement therapy (HRT), women take oestrogen to make up for the decrease in naturally-produced oestrogen that is associated with menopause. Doing this helps to ease many of the symptoms associated with the condition. Women who are suffering with vaginal dryness should find that lubricants or moisturisers for the vagina are useful supplements for vaginal oestrogen. Many women find that Cognitive Behavioural Therapy can improve sleeping patterns and help you to relax. This consists of lifestyle changes such as exercise, adapting to a healthier sleeping pattern and yoga.

What are the differences between the two types of HRT?


Hormone replacement therapy (HRT) can be oestrogen-only, or combined with progestogen. When taking an oestrogen-only HRT, this can increase the risk of your developing uterine cancer. For this reason, it is only advised that women who have had a hysterectomy take this form of treatment. Using combined HRT can heighten your risk of other forms of cancer, but only when your treatment has gone on for many years.

How long do I take HRT for?


Most women will be able to stop taking HRT after around two to five years, which is when many symptoms of the menopause stop. However, you should gradually reduce your hormone intake to stop the symptoms from coming back. Any recurring symptoms should stop after a few months. If they continue after this time, you may need to resume hormone replacement therapy at a lower dose than before. You can discuss the different types of treatment options available with your doctor. When you have finished hormone replacement therapy, you may need to seek other treatments as a prevention for vaginal dryness and/or osteoporosis.

How can I get HRT?


Our UK based pharmacy stocks a variety of hormone replacement treatments. Simply fill in an online consultation with one of our qualified pharmacists, and they will prescribe the most appropriate hormone replacement therapy treatment for your needs.

How does HRT affect your sex life?


Research has suggested that hormone replacement therapy boosts a post-menopausal woman's sexual interest and makes them feel more sexual in general.

What are the HRT side effects?


When a hormone replacement treatment is first taken, is can create side effects. Usually, side effects will improve over time as your body becomes accustomed to the medication. Both the combined HRT and oestrogen only HRT have their own potential side effects.

Side effects of oestrogen-only hormone replacement therapy include:

  • Swelling of the body and breast tenderness
  • Headaches
  • Indigestion or nausea
  • Vaginal spotting

Side effects of progesterone HRT include:

  • Acne
  • Low mood or depression
  • Vaginal spotting
  • Headaches
  • Stomach or back pain

If you are worried about any side effects, or if they are beginning to interfere with your daily life, visit your doctor for advice. It may be that your dose is too high, or an alternative treatment needs to be used.

Will HRT make you gain weight?


Many women believe that HRT makes them put on weight, but there is no evidence to support this idea.

Who should avoid using HRT?


Hormone replacement therapy (HRT) is not suitable for all women.

Do not use HRT treatments if you are pregnant or have a history or high risk of any of the following:

  • Heart disease
  • Liver disease
  • Breast cancer, uterine cancer or ovarian cancer
  • Blood clots or strokes

If you have any health issues like irregular periods or high blood pressure, these must be resolved before you can begin hormone replacement therapy.

What is osteoporosis?


Osteoporosis is when your bones become weaker as a result of lower oestrogen levels. It is particularly common in women who are going through menopause. Oestrogen from HRT can prevent this condition, but this effect will not last once the treatment is over. You can decrease your chances of osteoporosis in a number of ways: Stop smoking Cut down on how much alcohol you drink Get plenty of sunlight exposure for vitamin D production Eat plenty of fruit and vegetables, as well as sources of calcium like dairy Resistance and weight exercises Calcium and vitamin D supplements (speak to your doctor about which to use)

How do I cope with heavy periods during the menopause?


Heavy periods (menorrhagia) is a common problem for women between 30 and 50 years old. Sometimes, it is the result of an identifiable cause, including blood blisters, polyps, cysts or fibroids, but in some cases, it can be the result of a changing hormone balance that occurs during the menopause. It is sometimes the result of the process of ovaries ageing and falling. Heavy periods are often the cause of other illnesses, so you should speak to your doctor if you are suffering from this problem.

What treatments are available for heavy periods?


The most effective method of stopping heavy periods is to have a hysterectomy, where your uterus is removed. This procedure is a major operation that will require you to spend four days in hospital; the recovery period can be up to three months. However, there are safer and less severe alternative treatments available these days, so your doctor is far more likely to suggest one of the following:

  • Cyklokapron or tranexamic acid, which controls clotting within the uterine vessels to make the bleeding less severe. This can be taken up to 12 times a day and there are no significant side effects.
  • Mefenamic acid or Ponstan, which are anti-prostaglandins to reduce the pain and prevent heavy bleeding.
  • Mirena coil, which is a small device that you insert into your uterus. Releasing progestogen, it thins the uterine wall to lessen the periods. Irregular bleeding is a side effect that you will likely get initially, but this should stop as your body adjusts to the coil.
  • Cyclical progestogen hormones, which are pills containing progestogen, are taken for part of the menstrual cycle. Regulating menstruation, they prevent heavy periods from coming after a missed period. They may also help to prevent menopausal symptoms like hot flushes.

Surgical treatments are also an option. Your doctor may recommend that you have surgery to ablate the uterine wall, which is a one-day operation and is performed under anaesthetic. This operation will either help your periods to lighten or cease altogether.

What effect can HRT have on periods?


If you are using HRT for pre-menopausal symptoms, the treatment must have both oestrogen and progestogen given sequentially. With sequential HRT, you will take oestrogen daily and progestogen for at least 10 days a month. Doing this will continue your menstrual cycle; it has no effect on heavy periods, so this form of treatment should not be used to treat this problem. When you reach the menopause, sequential HRT can be switched to continuous combined HRT quite easily. During this routine, you will take oestrogen and progestogen daily. Your body should adjust to this after six months and you should not suffer from bleeding, anymore.

What causes vaginal dryness?


VD occurs when your vaginal tissues become thin and dry, which is a natural result of your oestrogen levels decreasing.

What treatments exist for vaginal dryness?


Systemic HRT is a treatment for VD, but if this is not an option, various tablets, waxy pessaries, creams and vaginal rings are available as alternatives. These topical oestrogen treatments help to relieve the problems of VD. There are also non-hormonal treatments, such as bio-adhesive vaginal moisturisers. You can purchase these over the counter. Prescription treatments such as Sylk, Replens MD and Yes are available, too.

Do you get your period when taking HRT?


This will depend on if you are still getting periods when your menopausal symptoms begin. Monthly HRT is normally recommended for women who are still having regular periods. If you have irregular periods, you will likely be recommended 3-monthly HRT, where you will have a period every three months. Maintaining regular periods means you will know when they naturally stop. This means you will be aware when you are likely to move to the final stage of the menopause. It is said that a woman is post-menopausal if she has not had a period for one year.

Is HRT for menopause the same as HRT for gender transition?


Certain medicines are used in both cases, such as progestogen and oestrogen medications, but they will be used differently for gender transition and be combined with other treatments.

Doctor Notes

Medicine Direct have an experienced clinical team of doctors, pharmacists and dispensers, all of whom are based in the UK. All are fully trained and qualified to provide appropriate and considered care across all areas of treatment we have available at our online pharmacy.

This means that no matter which member of our team is assigned to your case, you can rest assured that you are in the hands of a highly skilled medical professional, who possesses the compassion and clinical expertise to properly advise you on the best course of treatment.

We are fully regulated

All of our doctors and pharmacists are fully registered with both the General Medical Council (GMC), MHRA and the General Pharmaceutical Council (GPhC). Each member of our team has also worked in various clinic settings in the past, such as community pharmacies and NHS hospitals.

Sonia Khan Pharmacist at Medicine Direct

Sonia Khan
MPharm: 2076091


Pharmacist

This content has been written by James Nuttall and has been medically reviewed by our Pharmacist Sonia Khan. Sonia is our local on-site pharmacist responsible for dispensing a wide range of treatments to our patients on a daily basis.

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