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Hormone Replacement Therapy

Consultation & treatments

What is hormone replacement therapy?

Hormone replacement therapy (HRT) is used to relieve the symptoms of the menopause by replacing the hormones that the female body stops producing after the menopause. The menopause is when a woman’s ovaries stop producing an egg each month and the monthly cycle of periods stop. This normally occurs in her 50s, with the average age being 52 years.

The hormones that stop being produced to such an extent during the menopause are oestrogen and progesterone. As the levels fall, the symptoms of the menopause are experienced, including hot flushes, night sweats, loss of sex drive, thinning of the bones, mood swings and vaginal dryness. Most of the symptoms will pass within two to five years although vaginal dryness will tend to get worse if left untreated, and thinning and brittle bones can get worse with age. Falling levels of progesterone increase the risk of uterine (womb) cancer. HRT replaces the hormones and relieves these symptoms.

There has been a lot written in recent years about the appropriateness of HRT as, like most medicines, it does carry risks as well as benefits. It is certain that, even though it is a natural process, the menopause can seriously impact a woman’s quality of life and feeling of well-being. HRT is an effective way of managing its symptoms and can help women tremendously. It can also reduce the risk of brittle bones and cancer of the rectum and colon. This benefit is reduced in importance as long-term HRT is rarely recommended and these benefits are then lost.

However, all types of HRT increase the risk of breast cancer within one to two years of their use. The increased risk is greater with combined oestrogen and progesterone HRT and the risk is greater the longer HRT is used - this disappears within five years of stopping HRT. The detection of breast cancer can also be made more difficult by HRT. HRT also carries an increased risk of endometrial cancer and a small increased risk of ovarian cancer, as well as the risk of stroke and an increased risk of coronary heart disease in women who start combined HRT more than 10 years after the menopause.

On balance, most experts agree that if HRT is used for no more than five years, the benefits outweigh the risks. If HRT is taken for longer periods, though, individual benefits and risks must be considered very carefully by the doctor.

What HRT treatments are available?

There are many different approaches to HRT including tablets, patches, gels, creams and implants that can be inserted under local anaesthetic. Which one is right for you is best decided by a doctor, based on the main problems you are experiencing and your personal circumstances.

Here are some of the treatments we offer through the Pharmacy2U Online Doctor service (follow the links to find out more about each medicine):

Dixarit (clonidine) can be used to control flushing if hormones cannot be used. EvorelEvorel Conti and Evorel Sequi are patches that are applied to the skin and so do not involve taking tablets – but there can be problems with them not sticking to sweaty skin, which is a symptom that comes with the menopause. Climaval and Premarin are oestrogen-only HRT tabletsKliofemPremique and Prempak-C are all oestrogen and progesterone-containing tablets. Livial contains tibolone, which has oestrogenic and progestogenic activity.

Dixarit Dixarit Clonidine
Evorel Evorel Estradiol valerate
Evorel Conti Evorel Conti Estradiol hemihydrate
Evorel Sequi Evorel Sequi Estradiol hemihydrate
Climaval Climaval Estradiol Valerate
Premarin Premarin Conjugated oestrogens, equine
Kliofem Sequi Kliofem Norethisterone acetate
Premique Premique Estradiol Valerate
Prempak-C Prempak-C Conjugated oestrogens and Norgestrel
Kliofem Tablets Livial Tibolone