Hormone replacement therapy (HRT) is a treatment used to help menopause symptoms. It replaces the hormones oestrogen and progesterone, which fall to low levels as you approach the menopause.

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Menopause symptoms that HRT can help to treat include:

· hot flushes

· night sweats

· sleep problems

· mood swings

· anxiety and low mood

· vaginal dryness

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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.

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Oestrogen and progesterone are an essential part of period cycles, ovulation and pregnancy. They also keep your bones healthy. As you get older, the loss of these hormones can have a big effect on your body.

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To replace these hormones, you'll usually take a combination of oestrogen and progestogen. If you've had a hysterectomy to remove your womb you can take oestrogen on its own.

 

Who can take HRT

You can usually take HRT if you're having menopause symptoms.

But HRT may not be suitable if you:

· have a history of breast cancer, ovarian cancer or womb cancer

· have a history of blood clots – you may need to use patches or gels rather than tablets

· have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT

· have liver disease

· are pregnant – it's still possible to get pregnant while taking HRT, so it's important to use contraception until 2 years after your last period if you're under 50, or for 1 year after the age of 50

If any of these apply to you, alternatives to HRT may be recommended instead.

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Benefits of HRT

Relieving menopause symptoms

The main benefit of HRT is that it's effective at relieving most perimenopause and menopause symptoms, such as:

· hot flushes

· night sweats

· sleep problems caused by menopause

· anxiety and low mood caused by menopause

· vaginal dryness

You should find that your symptoms improve after a few days or weeks of taking HRT.

 

Preventing osteoporosis

Osteoporosis is thinning of the bones, which makes you more likely to have a fracture. It's common after the menopause because your level of oestrogen falls. Oestrogen is needed for healthy bones. (www.nhs/conditions/osteoporosis)

HRT helps to prevent osteoporosis by increasing your level of oestrogen.

It's particularly important to take HRT to help prevent osteoporosis if your periods stop before the age of 45 (early or premature menopause). (www.nhs.uk/conditions/early-or-premature-menopause/)

 

Maintaining muscle strength

It's common to lose muscle strength as you reach menopause. HRT can improve this and help your muscles stay strong. It's also important to exercise to keep your muscles strong.

 

Risks of HRT

The risks of any serious side effects are usually very low, and depend on the type of HRT you take, how long you take it and your own health risks.

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Breast cancer

HRT can slightly increase the risk of breast cancer. If you've had breast cancer, you'll usually be advised not to take HRT.

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The increased risk is low: there are around 5 extra cases of breast cancer in every 1,000 women who take combined HRT for 5 years, and some types of HRT don’t increase the risk for 5 years.

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The risk increases the longer you take it, and the older you are. It falls again after you stop taking it.

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There is little or no increase in the risk of breast cancer from oestrogen-only HRT, which you can take if you've had a hysterectomy to remove your womb.

You can reduce the risk of breast cancer by not taking HRT for longer than you need it to control your symptoms.

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There are also lifestyle changes that can reduce the risk of breast cancer.

(www.nhs.uk/conditions/breast-cancer/prevention/)

It's especially important to attend all your breast screening (mammogram) appointments (www.gov.je/breastscreening)

 

Blood clots

HRT tablets can increase the risk of blood clots, but the risk is still very low. HRT patches, sprays and gels do not increase the risk of blood clots. This is because oestrogen is safer when it's absorbed into your body through your skin.

If you're at risk of blood clots you'll usually be advised to use HRT patches, spray or gel rather than tablets.

 

Stroke

HRT tablets (but not patches, gel or spray) slightly increase the risk of stroke. But the risk is still very low, particularly if you're under 60 years old.

 

Research into HRT and other conditions

Research has shown that taking HRT has little or no effect on the risk of getting coronary heart disease. More research is being done to find out how taking HRT affects some other conditions, such as dementia and diabetes. Any increased risk or benefit is likely to be small.

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It's not known whether HRT reduces the risk of dementia.

HRT does not increase the risk of developing type 2 diabetes. Some recent studies have suggested that it may even slightly reduce the risk.

 

Benefits and risks of vaginal oestrogen

Vaginal oestrogen helps with vaginal dryness. It does not increase the risk of breast cancer, blood clots or other conditions.

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The dose is low and very little of the medicine gets into the rest of your body, so it's safe to use it for a long time.

 

Taken from: About hormone replacement therapy (HRT) - NHS Benefits and risks of hormone replacement therapy (HRT) - NHS

 

If you wish to discuss menopause and or HRT options, we have GP’s who have specialised in this area, so please make an appointment with Dr’s Bashforth, B Perchard, Le Gresley, Le Maistre or

Le Page.