Hormone therapy: what are your options?

During menopause, your body undergoes significant hormonal changes. Before your final period (during the perimenopause phase), oestrogen and progesterone levels drop considerably, while testosterone levels increase in relative terms. These hormonal changes cause symptoms in 80% of women. After menopause, your body seeks a new hormonal balance.

Hormone therapy is a treatment that temporarily supplements the hormonal deficiencies in your body during menopause. It helps to stabilise oestrogen and progesterone levels. As a result, symptoms caused by fluctuating and declining hormone levels may lessen or even disappear entirely.

Many women find menopause becomes more manageable. They sleep better, no longer experience hot flushes, gain relief from vaginal dryness or itching, feel more energetic, and suffer less from joint pain.

There are different types of oestrogen and progesterone used in hormone therapy:

• Bioidentical hormones: These are hormones identical to those naturally produced by your body and are broken down in the same way. They are derived from plants (such as soy). Examples include Lenzetto (bioidentical estradiol) or Utrogestan (bioidentical progesterone).
• Synthetic hormones: These have similar effects to natural hormones but have a different biochemical structure (for example, the contraceptive pill contains these hormones). They mimic the action of natural hormones. Synthetic hormones are produced in a laboratory. Examples include Utrogestan.

Most prescribed treatments contain bioidentical oestrogen (estradiol, the most active form of oestrogen produced by your body), which works exactly like the estradiol your body naturally produces. They often also include bioidentical progesterone or synthetic progestogens (such as levonorgestrel or dydrogesterone).

HRT can be administered in various ways. The best method depends on your symptoms and personal circumstances. Where possible, transdermal administration is often preferred. This avoids the liver, reducing the risk of side effects. This is particularly beneficial for women with an increased risk of thrombosis:

• Transdermal (through the skin): Gels, creams, and patches, such as Lenzetto. The hormones are absorbed through the skin, often requiring a lower dosage. Patches and creams usually provide more stable blood levels than gels, which can positively impact symptom relief.
• Oral (in pill form): Tablets and capsules, such as Femoston. These are easy to use. However, since the hormones are processed through the liver, the risk of side effects is higher.
• Vaginal: Creams and ovules, such as Estradiol. These deliver a low dose of oestrogen directly to the vagina, which can relieve vaginal symptoms like itching and dryness. Because it primarily works locally, it usually has less effect on the rest of the body and a lower risk of side effects.

It’s impossible to predict which form will work best for each individual. Some respond better to bioidentical hormones, while others benefit more from synthetic ones or a combination of both. Based on your symptoms and preferences, you can choose a treatment. The doctor will review your medical history to determine if it’s safe for you to start. If necessary, the doctor will recommend an alternative.

You and your doctor will also work together to find the right hormone dosage. The goal is to use as little as possible but as much as needed to reduce symptoms. The dosage is gradually increased. It may take a few months to find the right form and dosage.

How long you need to use hormone therapy depends on your circumstances and symptoms. Generally, doctors recommend stopping the treatment after five years. The priority is to treat long enough and taper off gradually in consultation with your doctor when you’re ready.

Due to potential side effects and risks, you should always start hormone therapy under a doctor’s supervision. At SeeMe-nopause, you’ll receive personalised menopause care guided by doctors. You can choose an intake with personalised product advice or, if you already know what you need, order directly with a medical review.

How does it work?

Choose the route that suits you. For an intake, you’ll complete a detailed medical questionnaire, after which a doctor will provide personalised product advice within 48 hours. If you already know which treatment you want, you can select a product directly. In both cases, a doctor will assess whether the treatment is safe and suitable for your circumstances.

Once approved, you’ll receive a prescription through a partnered pharmacy. Your order will then be delivered to your home within three days.

Not everyone can or wants to use hormones, for example, if you’ve had breast cancer. In such cases, there are other ways to help reduce symptoms. Even if you do use HRT or other medications, diet and lifestyle remain an important part of the treatment.

• Diet and lifestyle: A healthy lifestyle is always the foundation. Good nutrition, sufficient exercise, and relaxation impact your health and can reduce menopausal symptoms. Learn more about a healthy lifestyle.
• Hormone-free medication: For certain symptoms, such as hot flushes or weight gain, hormone-free medications are available. Examples include Veoza or Clonidine for hot flushes.
• Dietary supplements: Supplements can influence the production, conversion, or breakdown of hormones, helping to balance your hormonal system and reduce specific symptoms*. Doctors often recommend magnesium, omega-3, vitamin D, and a vitamin and mineral complex during menopause. View all supplements.

*Health claim pending approval by the European Commission.