Hormone Replacement Therapy (HRT) can feel like a minefield for women to navigate.
Does it work? Can I take it? What are the side effects?
Women also tell us they’re put off by what other women say and what their GPs have told them.
To help clear things up, here are some of the questions I’m most frequently asked, and the facts:
Is there a time limit for taking HRT?
You can take HRT for as long as you need to based around your own individual circumstances. There is no guidance that says the limit is 5 years. This is a myth we hear all the time. Personally I have many clients in their 60s, 70s and 80s who’ve been taking HRT for many years.
The only real timeframe is that if you started HRT below the age of 51 the NICE guidelines (guidance notes for GPs) say that you should take it until you are at least 51.
Can I take HRT if I’m still having periods?
Yes. It is simply not correct to say that you must have finished having periods before you can start HRT for a whole variety of symptoms. Indeed, HRT may be very useful as a way of regulating periods and making them more manageable at this time in your life; much like a teenager might go onto a contraceptive pill for period troubles.
Symptoms of declining ovary function may start some years before periods stop, and there is no harm at all in starting treatment as soon as it is needed.
I tried HRT once and it didn’t work for me. Why was that?
There’s a range of HRT products – some will better for you than others, so don’t give up if the first one you’re prescribed doesn’t work as well as you’d like.
A three-month trial is the right length of time to really see how you are getting on with something. If at that point you do not feel things are the best they can be for you, go back and discuss the results with your doctor and try another one.
Don’t give up. It may well be that a different variety or dose of treatment will work.
Does HRT just delay the menopause?
Some women tell us that they avoid taking HRT because it simply delays the inevitable, pushing back when they may experience menopausal symptoms. This is not true.
Any symptoms you might experience after stopping HRT are menopausal symptoms you would have experienced even if you had never taken HRT. Without HRT, many women have menopausal symptoms for more than a decade and some women still have hot flushes when they are over 75 years old.
If a woman still experiences menopause symptoms it means she’s come off HRT too early.
Can I take HRT if I suffer from migraines?
Many women notice that their migraines worsen as they go through their menopause. As you can’t take the oral contraceptive pill if you have a history of migraines, many women (and doctors) incorrectly think that you cannot take HRT if you have migraines.
If you have migraines, then you should take oestrogen as gels or patches rather than as tablets.
Am I just better off just trying to get through it?
If symptoms are getting in the way of enjoying life – or work – there is something you can do about it. Don’t wait until they’re unbearable. Keep a diary of your symptoms, both physical and psychological – list them in the order that they are bothersome.
Talk to your GP or a menopause expert. HRT may resolve some, all or none of the symptoms you’ve listed. But there are different treatments that you can try and do persevere until you’ve found the best one for you.
Usually I recommend reviewing how your symptoms are against your list after about three months to give them time to work. It’s best not to keep chopping and changing them.
Is HRT made from horses urine?
The first oestrogen HRT preparations were made from pregnant mare’s urine, as this was a very rich source of oestrogen. This type of oestrogen is still available under the name of ‘Premarin’. It works perfectly well and many women worldwide take it, but some women do not like the idea of it.
Other preparations are available that use oestrogen manufactured to be identical to the oestrogen made by women. These are made from plants and are called body-identical HRT.
Your own personal philosophy
Menopause is a pivotal moment in a woman’s life, and is a good time to look at all aspects of health, including your diet, exercise, mental health and stress.