Hormone replacement therapy (HRT)

What is MHT/HRT?

Menopausal hormonal therapy (MHT) is a new name for hormone replacement therapy (HRT). It is a type of hormone therapy used to treat the symptoms of menopause, especially hot flushes and night sweats. About 1 in 4 women have symptoms that need teatment with these hormone medicines. There are benefits and risks to HRT/MHT, so it is important to talk to your doctor if you are considering starting or stopping it.

The main types of HRT/MHT are based on hormones that are naturally found in the body, such as oestrogen and progesterone. In some cases, testosterone therapy is also used.

Many menopausal symptoms, such as hot flushes and night sweats, are due to low oestrogen levels. HRT/MHT can restore hormone levels, which may improve some menopause symptoms and quality of life.

What are the different types of HRT/MHT?

Thee are many different types of HRT/MRT available, and your doctor is the best person to help you consider your options.

The main hormone used in HRT/MHT is oestrogen. If you still have a uterus, you will also need to take progesterone to reduce your risk of endometrial cancer.

Some women benefit from a low-dose testosterone replacement to improve low sex drive. This needs to be discussed with your doctor as it is not right for everyone.

Other forms of HRT/MHT are tibolone (a type of steroid medicine) or other medicines known as SERMs (selective oestrogen receptor modulators).

There are other non-medical treatments that can also help you manage your symptoms – ask your doctor for advice on this.

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

What forms of HRT/MHT are available?

HRT/MHT can be taken as:

• oral tablets
• gels or patches (absorbed through the skin)
• creams and tablets placed in the vagina
• a hormonal intrauterine device (IUD)

What are the benefits of HRT/MHT?

HRT/MHT can be helpful if you have problems with hot flushes and night sweats. You may also find that your sleep, mood, sex drive, joint aches and vaginal dryness gets better.

HRT/MHT may have some benefits in reducing your risk of osteoporosis, heart disease, fractures, type 2 diabetes and some types of cancers. If you don’t have hot flushes or night sweats, your doctor probably wouldn’t recommend you start HRT to try and prevent these conditions.

What are the risks of HRT/MHT?

Some studies have shown that HRT/MHT can lead to a slightly increased risk of developing breast cancer, while other studies suggest that some specific types of HRT/MHT can lower your risk of breast cancer is lower. Because these risks are bansed on specific health factors, it’s best to have a full disucssion with your doctor before you decide if you want to start or stop taking HRT/MHT.

Some forms of oesterogen in HRT/MHT can increase your risk of blood clots, but using a cream is unlikely to increase the risk. Here too, in it is best to discuss your options with your doctor to see what the right choice is for you, before starting any medicine.

Current international recommendations say that the benefits of HRT/MHT outweigh the risks for females with significant menopause symptoms, and that HRT/MHT is effective and safe for most healthy females.

Side effects affect some, but not everyone who takes HRT/MHT and may include:

• nausea
• headache
• breast tenderness
• fluid retention
• bloating
• irregular bleeding.
• These side effects often go away within a few months.

HRT/MHT is not be suitable for you if you have or have had:

• breast cancer, endometrial cancer or other cancers that are dependent on hormones
• vaginal bleeding without a known cause
• a blood clot in a vein, such as those in the legs or lungs
• heart disease or stroke
• liver disease
• untreated high blood pressure

The risks of HRT/MHT depend on many factors including:

• your age
• the type and dose of hormone therapy you take
• how long you take it for
• your medical history
• If you can’t take HRT/MHT, your doctor may suggest other non-medical options and treatments that may be helpful.

How can I reduce the risks associated with HRT/MHT?

You can lower your risks associated with HRT/MHT by:

• starting at a low dose
• discussing with your doctor which form of HRT/MHT to use
• reviewing the dose regularly with your doctor
• checking with your doctor when it’s time to stop taking it

Exercising, eating well, not smoking and avoiding too much alcohol and caffeine can also help you stay healthy and manage your menopausal symptoms.

When should I see my doctor?

If you are have menopausal symptoms that affect your quality of life and want to know what treatments could help, talk to your doctor. They will be able to give you advice based on your personal medical history and symptoms.

If you are taking HRT/MHT and your symptoms are not getting better or you are experiencing side effects, speak to your doctor.

If you take HRT/MRT, you should see your doctor 6 months after starting treatment and regularly after that. Most specialists recommend using MHT for up to 4 to 5 years, but this will depend on your individual risks and symptoms.