Continuous combined hormone replacement therapy (HRT) is a medicine used to treat hot flushes, mood swings, vaginal dryness and other symptoms of the menopause.
It can also prevent weakening bones (oesteoporosis) which is common after the menopause.
Menopause is when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier. It affects anyone who has periods.
Your doctor will usually recommended continuous combined HRT if you are post-menopause (you have not had a period for 1 year or more).
It is not suitable if you have menopause symptoms but are still having periods (perimenopause), or within 12 months of your last period, because it may cause irregular bleeding. In these cases your doctor will usually recommend sequential combined HRT instead.
Menopause symptoms are caused by a drop in the levels of oestrogen and progesterone produced in the ovaries. There are different types of oestrogen and progesterone, called oestrogens and progestogens. Combined HRT uses both to raise the levels of these hormones in your body.
It's important to take both oestrogen and progestogen, unless you've had a hysterectomy (surgery to remove your womb). This is because taking oestrogen-based HRT on its own can thicken the womb lining. This slightly increases the risk of womb cancer. Taking progestogen together with oestrogen reduces the risk.
Continuous combined HRT is only available on prescription. It comes as tablets, capsules and patches.
Important: HRT shortages
Currently there are supply shortages of some types of HRT. If the medicine you've been prescribed is not available, a pharmacist or doctor will be able to advise you about using a different brand or type of HRT that is suitable for you.
Key facts
- You take continuous combined HRT every day without a break.
- HRT can take up to 3 months to work fully to improve your symptoms.
- Common side effects include headache, breast tenderness and vaginal bleeding but these normally improve in the first few months of treatment.
- If you feel that the HRT you're taking is not helping your symptoms, talk to a doctor. It can take time to find the right type and dose to suit you.
- It's common to take combined HRT for 2 to 5 years, and then try stopping to see if your menopause symptoms have improved. If your symptoms last for longer, your doctor can advise on the benefits and risks of continuing to take HRT.
- It's important to see your doctor at least once a year for a check-up and to review whether you need to keep taking HRT.