Hormone replacement therapy (HRT) - Types 

Types of HRT 

Choosing the right HRT for you

Finding the right type of HRT for you can be tricky. The advice below may help.

  • A low dose of HRT hormones is usually recommended to begin with. It is best to start with the lowest effective dose to minimise side effects. You can increase your dose at a later date.
  • Persevere with HRT. Give it a few months to see if it works well for you. If not, you can try a different type or increase the dose.
  • Talk to your GP about any problems you have with HRT.

Hormone replacement therapy (HRT) replaces two female hormones that a woman’s body is no longer producing due to menopause. These hormones are:

  • oestrogen: the oestrogen used in HRT is taken from plants or from the urine of pregnant horses
  • progesterone: HRT uses a synthetic version of progesterone called progestogen because it is easier for the body to absorb

While there are more than 60 different preparations of HRT, the three main types are discussed below.

Oestrogen-only HRT

Oestrogen-only HRT is usually recommended for women who have had their womb and ovaries removed during a hysterectomy. There is no need to take progestogen because there is no risk of endometrial cancer (cancer of the lining of the womb).

Cyclical HRT

Cyclical HRT, also known as sequential HRT, is often recommended for women who have menopausal symptoms but still have their periods.

There are two types of cyclical HRT:

  • monthly HRT: where you take oestrogen every day and progestogen at the end of your menstrual cycle for 14 days
  • three-monthly HRT: where you take oestrogen every day and progestogen for 14 days, every 13 weeks

Monthly HRT is usually recommended for women having regular periods. You will continue to have monthly periods until the menopause causes them to stop.

Three-monthly HRT is usually recommended for women experiencing irregular periods. You should have a period every three months.

It is useful to maintain regular periods so you know when your periods naturally stop and when you are likely to progress to the last stage of the menopause.

In some cases a woman using cyclical HRT may continue having periods after the menopause (when she is post-menopausal).

Continuous combined HRT

Continuous combined HRT is usually recommended for women who are post-menopausal. A woman is usually said to be post-menopausal if she has not had a period for a year.

As the name suggests, continuous HRT involves taking oestrogen and progestogen every day without a break.


Page last reviewed: 11/05/2012

Next review due: 11/05/2014

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Pregnancy and HRT

Oestrogen used in HRT is different from oestrogen used in the contraceptive pill, and is not as powerful.

This means it is possible to become pregnant if you are taking HRT to control menopausal symptoms. In some cases, a woman can be fertile for up to two years after her last period if she is under 50, or for a year if she is over 50.

If you don't want to get pregnant, use a non-hormonal method of contraception, such as a condom or diaphragm.