Question 1

How can I get HRT?

Accepted Answer

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.

Question 2

How does HRT affect your sex life?

Accepted Answer

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

Question 3

What are the HRT side effects?

Accepted Answer

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.

Question 4

Will HRT make you gain weight?

Accepted Answer

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

Question 5

At what age does menopause start?

Accepted Answer

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.

Question 6

What is premature menopause?

Accepted Answer

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.

Question 7

What are the symptoms of menopause?

Accepted Answer

The key symptoms are: Low mood, anxiety or depression; Vaginal dryness; Hot flushes and night sweats; Reduced libido; Difficulty remembering; Memory loss. Further information can be found under the Symptoms tab on this page.

Question 8

For how long do these symptoms last?

Accepted Answer

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.

Question 9

What are the risks of HRT?

Accepted Answer

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.

Question 10

What are hot flushes?

Accepted Answer

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.

Question 11

What treatments are available for the symptoms of menopause?

Accepted Answer

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.

Question 12

What are the differences between the two types of HRT?

Accepted Answer

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.

Question 13

How long do I take HRT for?

Accepted Answer

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.

Question 14

Who should avoid using HRT?

Accepted Answer

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.

Question 15

What is osteoporosis?

Accepted Answer

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).

Question 16

How do I cope with heavy periods during the menopause?

Accepted Answer

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.

Question 17

What treatments are available for heavy periods?

Accepted Answer

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.

Question 18

What effect can HRT have on periods?

Accepted Answer

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.

Question 19

What causes vaginal dryness?

Accepted Answer

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

Question 20

What treatments exist for vaginal dryness?

Accepted Answer

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.

Question 21

Do you get your period when taking HRT?

Accepted Answer

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.

Question 22

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

Accepted Answer

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.