- HRT replaces the oestrogen your body no longer produces, relieving symptoms.
- If you have a uterus, you must also take a form of progesterone.
- HRT can be delivered via tablets, patches, or gels.
- The 'best' type depends on your personal health profile and lifestyle.
What is Hormone Replacement Therapy?
Hormone Replacement Therapy (HRT) works by replacing the hormones that your ovaries stop producing during menopause. The main hormone is oestrogen, which is responsible for managing many functions in your body. Taking oestrogen alleviates symptoms like hot flushes, night sweats, poor sleep, and mood changes.
If you still have your uterus, you must also take a form of progesterone. This is called combined HRT. Progesterone protects the lining of the womb (the endometrium) from the thickening effects of oestrogen, reducing the risk of endometrial cancer.
Through the Skin: Patches and Gels
Transdermal HRT means the oestrogen is absorbed through your skin. This includes patches, which you stick on your skin and change twice a week, and gels or sprays, which you apply to your skin daily. It's a very popular choice for women in the UK.
The key advantage is that the oestrogen goes directly into your bloodstream, bypassing the liver. This method is associated with a lower risk of developing blood clots compared to oral tablets, making it a safer option for many women. Some find patches can cause skin irritation, while gels require careful application.
By Mouth: Tablets
Oral HRT involves taking a daily tablet that contains oestrogen, and often progesterone as well. For many women, this is the simplest and most convenient method. There's no need to worry about applying a gel or a patch falling off.
The main trade-off is that when oestrogen is processed by the liver, it can slightly increase the risk of blood clots. While this risk is still very small for most healthy women, it's something we consider carefully when weighing up the options, especially if you have other risk factors.
How to Choose the Right Type for You
The right HRT for you depends on your symptoms, your medical history, and your personal preference. For example, if you have a history of migraines, transdermal HRT is often recommended. If you value convenience above all, tablets might be your preference.
Navigating the options and the HRT shortages sometimes seen on the NHS can be challenging. A detailed discussion with a doctor allows you to weigh the pros and cons of each method and create a plan that fits your life and health needs perfectly.
Frequently asked questions
Is one type of HRT safer than another?
Transdermal oestrogen (patches and gels) is associated with a lower risk of blood clots compared to tablets, as it's absorbed directly into the bloodstream, bypassing the liver. The choice depends on your personal medical history, which is why a consultation is essential.
Can I switch between different types of HRT?
Yes, it's quite common to switch. You might start on one type and find the delivery method doesn't suit your lifestyle, or you may experience side effects. Your doctor can guide you on how to change from a patch to a gel or tablet safely.
How long does it take for HRT to work?
Most women start to feel the benefits within a few weeks to three months. It can take time for your body to adjust, so we usually recommend trying a specific dose and type for at least three months before making any changes.
Do I still need contraception while on HRT?
Yes. HRT is not a contraceptive. If you are still having periods, you need to use contraception until two years after your last period if you are under 50, or for one year if you are over 50.
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