There is a lot of misinformation about hormone replacement therapy (HRT). There are some risks but many find it helpful to ease their symptoms.
HRT tops up the low levels of hormones (oestrogen and progesterone) caused by the menopause and so alleviates the symptoms. Because oestrogen is important for healthy bone growth, HRT can protect a woman’s bones from osteoporosis.
The benefits of HRT include:
- Relief from hot flushes.
- Relief from vaginal dryness, urinary frequency/urgency and recurrent urinary tract infections.
- Improvement of sex drive (libido).
- Reduced risk of fractures associated with osteoporosis.
- Reduced risk of bowel cancer.
The risk of HRT is that it slightly raises your chance of developing certain conditions. These are:
- Breast cancer
- Endometrial cancer
- Ovarian cancer
- Blood clots (embolisms)
- Deep vein thrombosis
- Stroke
A large number of medical studies were conducted between 2000 and 2004 which looked at HRT and the major health problems faced by postmenopausal women. These studies received a lot of negative publicity. As a result of the publicity some women have felt reluctant to use HRT.
While there are risks, most experts agree that if HRT is used on a short-term basis (no more than five years) the benefits of HRT outweigh any associated risk. See Useful links.
Your GP will be able to discuss the risks and benefits of HRT with you. However, in some circumstances your GP will want you to see a menopause specialist before prescribing HRT. Such circumstances include if you have had a hormone-dependant cancer such as breast cancer or cancer of the womb or if you have had a blood-clotting condition such as angina or a heart attack. The specialist will be able to advise you on whether or not HRT is right for you.
HRT myth buster
Below are some of the common misconceptions about HRT, and the facts you need to make up your own mind.
I’ve tried it and it didn’t work.
There are over 50 different types of HRT that can be taken in a number of different ways: orally, in tablet form; through the skin via patches or gels; or as a long-lasting implant. So try different formats to find one that suits you.
If I’m on HRT, I can’t get pregnant.
You can still get pregnant when you are taking HRT. It is not a contraceptive. Continue to use contraception for two years after your last period if under the age of 50 or one year after the age of 50.
If I have had a hysterectomy, I don’t need HRT.
This isn’t necessarily the case. The best HRT for women who have had a total hysterectomy (removal of the whole womb including the cervix) is oestrogen alone. Combined HRT (oestrogen and progestogen) does not offer an added benefit and may increase the risk of breast cancer for these women.
Women who have had a partial hysterectomy may still have some womb lining present. Because of this, combined HRT may be necessary.
Complementary therapy is a safer alternative.
It’s easy to think that complementary or alternative therapies are a harmless alternative to HRT and may ease menopausal symptoms. But there is no medical evidence that the many unlicensed complementary therapies available are effective. They can have unpleasant side effects, can interfere with other medications and can be potentially harmful.
For a detailed guide to HRT, see the Useful links. You will find questions to ask your GP or specialist, and information on who can use HRT, dosage, side effects and also the disadvantages.