Herstmonceux Integrative Health Centre

Hailsham Road, Herstmonceux, East Sussex, BN27 4JX

Telephone: 01323 833535


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Hormone replacement therapy, or HRT, has changed in the last 5 – 10 years. It has become safer, is more talked about and is now quite commonly used by women who have symptoms of the menopause. Why? Oestrogen was often given in a tablet form in the past. Now that skin patches and oestrogen gel are available it means that oestrogen can treat symptoms of the menopause using a far lower dose, which means lower potential risks. And it is no longer made from horses urine!

( Oestrogen pessaries or cream that is applied to the vaginal area does not count as HRT because it is not absorbed into the whole body, it only works where you put it. )

The other significant shift, which makes HRT safer than it used to be, is that the type of progesterone has also changed. Progesterone needs to be given to balance the oestrogen patch or oestrogen gel in any woman who still has a womb. Progesterone is still given in tablet form, however the type that is available today is called a micronised natural or bio-identical progesterone and is made from yams.

Women under the age of 52 will still need contraception. The progesterone that is in a hormone infused coil, such as a ‘Mirena’ is enough to balance oestrogen given as HRT. After the age of 52 we recommend the coil is taken out and micronised progesterone taken instead. If you are interested to read a summary of recent evidence published in the British Medical Journal, which is written in plain English, click here.

The symptoms of the menopause, which are caused by a lack of oestrogen include; brain fog, difficulty concentrating, insomnia, loss of motivation, muscle aches and pains, urinary frequency, weight gain and loss of libido. These are common and less well known than the classic hot sweats which are experienced by most but not all women.

The first question to ask with any medication is what are the risks, and secondly, are the benefits of it for me worth those increased risks  ?

HRT is not generally recommended for those with genetically linked forms of breast cancer, or a very strong family history, or who have had breast cancer themselves. Oestrogen pessaries and cream used vaginally to prevent vaginal atrophy are thought to be safe for these women to use.

There is a known increase in breast cancer risk for those taking HRT, so HRT should only be taken if the lack of oestrogen is having a significant effect on a woman’s life and wellbeing. It has been suggested that this increased risk is similar in scale to the added risk if you were to drink an extra glass of wine every day. Being above your healthy weight increases your risk of breast cancer, and so does any alcohol that you drink.

It is recommended that you try to be ‘breast aware’ at all ages and consider whether your breasts have changed when you look in the mirror or shower. As you get older you may want to check your breasts more carefully. This video from Breast cancer UK shows what to look for.

Myths about HRT

  • If you take HRT you will simply delay your menopause symptoms – This is not true
  • If you start HRT you won’t be able to stop it – HRT can be stopped at any time, by gradually reducing the amount of gel over several weeks or cutting patches in half. When it is no longer helping, or symptoms have gone or reduced to a manageable level without it, it can be stopped.
  • The menopause is natural and therefore ‘normal’ . It is a natural process however our ‘natural’ life span has increased  from around 45 years in the Middle Ages and women are wanting more options to feel well and healthy at all stages of life, according to what suits them.