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Hormone replacement therapy (HRT), widely recognized for its efficacy in reducing common menopause symptoms such as hot flushes and night sweats, is now the subject of new research exploring its broader potential.
According to NHS guidance, the treatment works by replenishing the hormones estrogen and progesterone, which naturally decline as women approach menopause.
Recently, US researchers studied a comprehensive dataset of more than 120 million patient records.
Their analysis specifically compared the outcomes of estrogen therapy started during perimenopause – the transitional stage before menopause – versus treatments administered after menopause or not at all.
Their findings showed that women who started estrogen therapy at least 10 years before menopause had about a 60 percent lower risk of having breast cancer, heart attack or stroke than those who started treatment later or did not take hormones.
We spoke to Dr. Ellis dallasWomen’s Health GP and Menopause Specialist London General PracticeWho explained clearly what the treatment involved and what women could expect when starting it.
talk to your doctor
“First, have a proper conversation with someone who knows what they’re talking about, who is giving you a very balanced perspective, and not pushing you in one direction or another, so you can make the choice that’s right for you,” Dallas advises. “It’s about saying, these are your circumstances, your background health, your family history, your risk and your symptoms.”
It is important to look at your individual circumstances as HRT is not suitable for everyone. “People who would not be candidates will have a history of hormonal cancer in their personal history,” says Dallas. “If someone has a really strong family history, such as the BRCA gene, or is at extreme risk of clots — then this requires subtle interactions. We always have to weigh the risks versus the benefits, so in these cases the benefits may not outweigh the risks.”
fill out a symptom checker
Secondly, Dallas advises people to fill out a free symptom checker to see if your symptoms tick any of the boxes for HRT. “If you’re experiencing symptoms like hot flushes or night sweats, it’s probably being caused by a hormonal component,” says Dallas.
Discuss your options
Then, if you think HRT is for you, discuss your options with your doctor.
“In the beginning it’s a conversation about expectations, lifestyle, whether they still need contraception and what might work best for them,” says Dallas.
“For example, estrogen comes in sprays, a pump gel, or sachet gels. So, if people travel a lot for their job, they may want to consider something like Sandrena, which has smaller sachets that may be easier to take with them.
“Some people like a patch that you have to change twice a week, while some people like to use a gel spray every day. So, it’s all about personal preference.”
three month trial
Then, you have the possibility to test the HRT method of your choice.
“There’s no need to panic, it’s extremely safe,” says Dallas. “We’re just increasing your natural hormones for three months and seeing if that makes a difference and seeing if you feel better.
“Most people will notice a difference after about two to four weeks of using estrogen, especially for physical symptoms like hot flushes and pain. However, for testosterone [often used alongside traditional HRT]It is very slow and may take about four to five months to notice if it is really making a difference.
Participate in review and provide input if necessary
You can change your dosage, methods or decide to discontinue it altogether at your annual review.
“See if you want to stay on it for a year, and then if you like it, review every six months or a year or when symptoms change,” says Dallas.
“A lot of people change the type of HRT they’re on because it will change according to where you are in your menopause, what your symptoms are, how you’ve responded to it.”
There is also no time limit on how long you can stay on it.
“You used to have to take someone off HRT after five years, but now there’s no time limit,” says Dallas. ,patients If they really wanted to they could stay on it until their death, as long as they are doing annual reviews and checking that all the benefits still outweigh the risks for that person. If people ask to get off it, we will very slowly remove them from it.”
The most important thing to remember is that this is a long-term process.
“Remember this is a journey,” says Dallas. “You can always try something and see how you feel. You can always fill out the symptom questionnaire again and wonder if it was the HRT that made a difference.”