Hormone replacement therapy (HRT) – Types – NHS

Different types of hormone replacement therapy (HRT) areavailable.

If you're considering HRT, talk to your GP about the options suitable foryou, as well as possible alternatives to HRT.

HRTreplaces thehormones that a woman's body no longer produces because of themenopause.

The 2 mainhormones used in HRT are:

HRT involves either taking both of these hormones (combined HRT) or just taking oestrogen (oestrogen-only HRT).

Oestrogen-only HRT is usually onlyrecommended if you have had your womb removed during ahysterectomy.

HRT comes in several different forms. Talk to a GP about the pros and cons of each option.

Tablets are 1 of the most common forms of HRT. They are usually taken once a day.

Both oestrogen-only and combined HRT are available as tablets. For some women this may be the simplest way ofhavingtreatment.

However,it's important to be aware that some of therisks of HRT, such as blood clots, are higher with tablets than with other forms of HRT (although the overall risk is still small).

Skin patches are also a common way of taking HRT. You stick them to your skin and replace them every few days.

Oestrogen-only and combined HRTpatches are available.

Skin patchesmay be a better option than tablets if you find it inconvenientto take a tablet every day.

Using patches can also help avoid some side effects of HRT, such as indigestion, and unlike tablets, they do notincrease yourrisk of blood clots.

Oestrogen gel is an increasinglypopular form of HRT. It's rubbed onto your skin once a day.

Like skin patches, gel can be a convenient way of taking HRT and does not increase your risk of blood clots.

Butif you still have your womb, you'll need to take some form of progestogen separately too, to reduce your risk of womb cancer.

HRT also comes as small pellet-like implants that are inserted underyour skin (usually in thetummy area) after your skin has been numbed with local anaesthetic.

The implantreleases oestrogen gradually and lasts for several months before needing to be replaced.

This may be a convenient option if you do not want to worry about taking your treatment every day or every few days. But if you still have your womb, you'll need to take progestogen separately too.

If you're taking a different form of oestrogen and need to take progestogen alongside it,another implant option is theintrauterine system (IUS). An IUS releasesa progestogen hormone into the womb.It can stay in place for 3 to 5 years and also acts as a contraceptive.

Implants of HRT are not widely available and are not used very often.

Oestrogen is also available as a cream, pessary or ring that is placed inside your vagina.

This can help relieve vaginal dryness, but will not help with other symptoms such as hot flushes.

It does not carry the usual risks of HRT and does not increase your risk of breast cancer, so you can use it without taking progestogen, even if you still have a womb.

Testosterone is available as a gel that you rub onto your skin. It is not currently licensed for use in women, but it can be prescribed after the menopause by a specialist doctor if they think it might help restore your sex drive.

Testosterone is usually only recommended for women whose low sex drive (libido) does not improve after using HRT. It is used alongside another type of HRT.

Possible side effects of using testosterone include acne and unwanted hair growth.

Ask a GP for more information on testosterone products.

Your treatment routine for HRT depends on whether you're in the early stages of the menopause or have had menopausal symptoms for some time.

The 2 types of routines arecyclical (or sequential) HRT and continuous combined HRT.

Cyclical HRT, also known as sequential HRT, is often recommended for women taking combined HRT whohave menopausal symptoms but still have theirperiods.

There are 2 types of cyclical HRT:

Monthly HRT is usually recommended for women having regular periods.

3-monthly HRT is usually recommended for women having irregular periods. You shouldhavea period every 3 months.

It's useful to maintain regular periods so you know when your periods naturally stop and when you're likely to progress to the last stage of the menopause.

Continuous combined HRT is usually recommended for women who are postmenopausal. A woman is usually saidtobe postmenopausal if she has not had a period for 1 year.

Continuous combined HRT involves taking oestrogen and progestogen every day without a break.

Oestrogen-only HRT is also usually taken every day without a break.

Page last reviewed: 09 September 2019 Next review due: 09 September 2022

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Hormone replacement therapy (HRT) - Types - NHS