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What is HRT?


Hormone Replacement Therapy is the use of oestrogen, progesterone and sometimes testosterone to treat the discomforts of the menopause or to replace hormone (especially oestrogen) lost after the menopause The aim of treatment is to alleviate symptoms using as low a dose of hormones as possible, and replacing what is naturally missing.

Benefits of HRT
HRT will relieve the immediate short term symptoms of the menopause that are caused by the lack of oestrogen. These include hot flushes, night sweats, tiredness, vaginal dryness, headaches, and irritability. Evidence shows that oestrogen is effective in treating hot flushes and improvement is noted within four weeks, with maximum therapeutic response usually achieved by three months when progress should be reviewed. Treatment should be continued for at least one year, otherwise symptoms often return. HRT can also help with long-term symptoms by preventing bone loss and so protecting against osteoporosis and reducing the risk of fractures.
If you have had a hysterectomy and no longer have a womb, you will need only oestrogen. If you still have a womb (or uterus), you will also need to take another hormone called progesterone. It is important to take progesterone for your womb to stay healthy.

Contraindications to HRT
• Endometrial Cancer (lining of the womb)
• Breast Cancer
• Pregnancy
• Undiagnosed abnormal bleeding
• Severe active liver disease

There are more than 50 HRT preparations, which feature different strengths, combinations and routes of administration, licensed in the UK. You can choose tablets, patches, implants, gels, nasal spray, vaginal cream or vaginal pessaries. The choice can be changed if you feel you are not benefiting from the initial preparation you started. Sometimes reducing or increasing the dose, changing the route of delivery may be all that is equired. It is recommended that a trial of three months is given before changing preparations.

How long should HRT be taken?
The duration of therepy depends on the women’s needs and her choice. Although menopausal symptoms usually resolve within 2-5 years, some women experience symptoms for many years. Some women will be happy to take HRT for life, others may wish to stop after 5-10 years because of the small but measurable increase in risk of breast cancer associated with the long-term use of combined HRT. Older women need less oestrogen to control symptoms and so a lower dose can be tried before stopping treatment.



©2003 - 2011 Dr Paul Fogarty