Hormone replacement therapy can alleviate menopausal symptoms such as hot flushes, night sweats, and vaginal dryness. Various treatments are available, and the most suitable option for you will depend on your symptoms, health, and personal preferences.
During menopause, your body produces less oestrogen, which can lead to a variety of symptoms. Hormone replacement therapy (HRT/HT) compensates for this deficiency, helping to reduce these symptoms.
Some treatments work systemically throughout your body, while others are designed to act locally.
In the video below, our specialist explains how hormone replacement therapy works and explores the available options.
Hormone replacement therapy is the most effective treatment for hot flushes and night sweats. It can also provide relief for other menopausal symptoms.
Not every treatment is appropriate for every situation. Find out which options are most relevant to you based on your symptoms and preferences.
Hot flushes and night sweats: These symptoms may occur less frequently and become less severe.
Sleep problems: Improved sleep may result from fewer night sweats and hot flushes.
Vaginal dryness: Local oestrogens can alleviate dryness, irritation, and discomfort during intercourse.
For other symptoms, such as mood swings and joint pain, the evidence of effectiveness is less clear.
Hormone replacement therapy can quickly and safely relieve menopausal symptoms for many women.
Improvements are often noticeable within two to three weeks. After approximately three months, you and your doctor can evaluate how well the treatment is working.
Hormone replacement therapy comes in various forms. The most suitable option depends on your symptoms, health, and preferences.
Through the skin
Patches, gels, or sprays allow hormones to be absorbed through the skin, providing systemic relief.
By mouth
Tablets or capsules also work systemically but may carry different risks compared to hormones absorbed through the skin.
Local treatment
Vaginal creams, tablets, or rings primarily address vaginal symptoms and are not effective for hot flushes.
If you have a uterus and use systemic oestrogen, you will typically also need a progestogen to protect the uterine lining.
Many women experience symptoms during menopause. Fortunately, there are ways to manage them. A variety of treatments are available, depending on your preferences and medical history. For multiple symptoms, a combination of treatments is often the most effective approach. If hormone replacement therapy is not suitable or not your preferred choice, the following options can offer additional support.
Treatment per symptom, alternative to hormone replacement therapy
Natural and free from hormones
The foundation for a healthy body
While hormone replacement therapy can effectively relieve menopausal symptoms, it is not without potential risks. These risks depend on factors such as your age, health, the type of hormones used, and the duration of treatment. Systemic hormone replacement therapy carries different risks compared to local vaginal treatments. Your doctor will discuss these considerations with you.
Thrombosis and stroke: Oestrogen in tablet form increases the risk of thrombosis. Large studies have not found an increased risk with oestradiol delivered through the skin. If you also use a progestogen, progesterone and dydrogesterone appear to carry a lower thrombosis risk compared to some other types. Hormone replacement therapy may slightly increase the risk of stroke, with factors such as age, dosage, and method of administration playing a role.
Breast cancer: Hormone replacement therapy combining oestrogen and a progestogen increases the risk of breast cancer, particularly with prolonged use. For example, in one model, five years of use starting at age 50 increased the risk of breast cancer between the ages of 50 and 80 from approximately 10% to 11%. Your personal risk also depends on factors such as family history of breast cancer, post-menopausal weight gain, alcohol consumption, and smoking. After stopping hormone replacement therapy, the additional risk gradually decreases. With oestrogen-only therapy, little to no additional risk has been observed. It remains unclear whether the type of progestogen affects this risk.
Endometrium: If you have a uterus and use systemic oestrogen, a progestogen is necessary to protect against uterine cancer. Without adequate protection, the risk of uterine cancer increases.
Local vaginal oestrogen: Only a small amount of oestrogen enters the bloodstream with this treatment, and serious side effects are rare. Studies have not shown a clear increase in breast cancer risk. If you have a history of breast cancer, your doctor will determine the most appropriate treatment for you.
Hormone replacement therapy that works throughout your body reduces the risk of bone fractures while you are using it. Some other health risks also appear to be more favourable in women who begin treatment before the age of 60 or within ten years of their last menstrual period.
Recent studies also suggest potential benefits for the heart and blood vessels. Swedish research indicates that the risk of heart disease is more favourable with hormone replacement therapy delivered through the skin compared to certain tablets. A large Danish study observed a slightly lower mortality rate in women who used hormone replacement therapy for several years.
Whether hormone replacement therapy helps to prevent dementia remains uncertain. The favourable study results also do not confirm that women live longer because of hormone replacement therapy. Other differences between the women studied may have influenced the outcomes. For this reason, guidelines advise against starting hormone replacement therapy solely to prevent cardiovascular disease or dementia, or to extend lifespan. Alleviating menopausal symptoms continues to be the primary objective.