If you have menopause symptoms that are bothering you or impacting your day-to-day life, you can talk to your GP about treatment options like HRT.

You can take HRT during perimenopause, when you have menopause symptoms before your periods stop and after your periods stop (post-menopause).

If you experience premature menopause (before the age of 40) or early menopause (before the age of 45), your doctor will usually recommend HRT or the combined pill. This is to protect you from osteoporosis and other conditions that can develop after the menopause.

Find out more about early menopause

HRT will be different for each person and may not be suitable for you if you:

• have a history of breast cancer, ovarian cancer or womb cancer
• have untreated high blood pressure
• have liver disease
• have undiagnosed vaginal bleeding
• are pregnant – you can still get pregnant while taking HRT. It’s important to use contraception until 2 years after your last period if you’re under 50, or for 1 year after the age of 50

Your doctor may recommend that you take HRT in a different form if you:

• have a history of blood clots – you may need to use patches or gels rather than tablets
• have a higher risk of blood clots, for example, if you are obese – you may need to use patches or gels rather than tablets

If you’re thinking about HRT treatment to help with menopause symptoms, speak to your GP about your options.

Find out about the different forms of HRT here

What are the benefits of hormone replacement therapy (HRT)?

Hormone replacement therapy (HRT) is a medicine used to treat perimenopause and menopause symptoms. It can also help with other health problems.

The benefits of taking HRT will be different for each person. For many people, especially within ten years of the menopause, the benefits of HRT are greater than the small risks.

Your GP can help you decide if HRT is right for you.

Find out more about what HRT is and what the types of HRT are

You can also find out more about the menopause

HRT and menopause symptoms

The main benefit of HRT is that it’s effective in treating most perimenopause and menopause symptoms like:

• hot flushes
• night sweats
• sleep problems
• mood swings
• anxiety
• low mood
• vaginal dryness

HRT and osteoporosis

The menopause increases the risk of your bones getting weak. As your bones get weaker and thinner, they may break more easily (osteoporosis). This is because you need oestrogen for bone strength and your oestrogen levels fall during menopause.

HRT helps to prevent osteoporosis by increasing your oestrogen level. Your risk of osteoporosis decreases while you’re on HRT and may remain low if you take HRT for longer.

It’s important to take HRT (or the combined pill) if you can to prevent osteoporosis if you started menopause before the age of 45 (early menopause).

It’s also important to exercise regularly and include weight-bearing, where your feet and legs support your weight (like walking or running) and resistance exercises (like using weights). Find out about exercising if you have an increased risk of breaking bones.

Your GP should give you advice about bone health and osteoporosis at your first appointment and when you go for your review.

HRT and muscle strength

Muscle mass and strength reduce with age and after the menopause. Exercise, especially weight-bearing exercise, where your feet and legs support your weight (like walking or running), can help prevent this. HRT may also be helpful.

What are the common side effects of hormone replacement therapy (HRT)?

Like any medicine, the hormones used in HRT can cause side effects. Most people have no side effects or only have mild side effects from taking HRT.

Side effects usually improve over time so it’s a good idea to carry on taking HRT for 3 months if possible. Side effects can also be similar to menopause symptoms so it may not be your HRT that’s causing them. Your GP should tell you what to expect when you start taking HRT.

To help with side effects, your GP might suggest changing your dose or trying different types of HRT to find what works best for you.

Speak to a GP if you have severe side effects, or you have side effects for longer than 3 months.

Common side effects of HRT can include:

• headaches
• breast pain or tenderness
• feeling sick (nausea)
• mood changes, including low mood or depression
• unexpected vaginal bleeding or spotting. This is a common side effect of HRT during the first 3 months of treatment

Although it’s rare, HRT medicines can cause serious side effects in some people. The NHS has more information about both the common and serious side effects of HRT.

HRT and weight gain

During the menopause, the change in hormones can mean that the body stores more fat and doesn’t burn calories as easily, however, there’s little evidence to show that HRT causes weight gain.

If you can, regular exercise and eating a balanced diet may help you manage your weight.

What are the risks of hormone replacement therapy (HRT)?

Research shows that for most women, HRT works and the risks of serious side effects from HRT are low. The risks associated with HRT are usually very small. Your risk will depend on many factors like the type of HRT you take, how long you take it and your health risks.

Your GP can help you decide if HRT is the right treatment for you and which type of HRT may be best for you.

HRT and blood clots

Oral HRT in the form of tablets can increase your risk of developing blood clots but the risk is very small.

If you have had blood clots before or you’re at risk of blood clots, you may be prescribed another form of HRT. You may be at high risk of blood clots if you’re obese for example.

Forms of HRT like sprays, gels or patches do not increase your risk because oestrogen is absorbed through your skin. Find out about the different forms of HRT. The NHS also has more information about the advantages and disadvantages of different forms of HRT.

HRT and breast cancer

If you’ve had breast cancer or you’re at increased risk of breast cancer, you’ll usually not be advised to take HRT.

Combined HRT (oestrogen and progestogen) can slightly increase the risk of breast cancer.

The risk may be higher if you take HRT for a long time. There are around 5 extra cases of breast cancer in every 1,000 women who take combined HRT for 5 years. The risk of breast cancer from combined HRT falls over time when you stop taking HRT. Women’s Health Concern has more information about HRT and understanding the risks of breast cancer.

There’s little or no increased risk of breast cancer from oestrogen-only HRT.

Cancer risk from HRT also generally depends on things like your age and general health. The risk of getting breast cancer from lifestyle aspects like smoking, not being active and regularly drinking alcohol is much higher than the risk of breast cancer from HRT.

It’s important to attend your breast screening (mammogram) appointments while you’re taking HRT.

Heart disease and stroke

HRT tablets (but not patches or gels) slightly increase your risk of having a stroke. It’s important to remember that the risk of stroke in women under 60 is very low.

Research has shown that taking HRT has little or no effect on the risk of getting coronary heart disease.

HRT and other conditions

HRT does not increase your risk of type 2 diabetes and isn’t likely to affect your blood sugar. If you have health problems related to your diabetes, your GP may ask a specialist for advice before offering you HRT.

It’s also not known if HRT affects your risk of developing dementia or reduces the risk of dementia. More research needs to be done into this.

Getting support

• NICE has more information for the public about HRT and other ways of managing menopause symptoms
• Women's Health Concern offers expert menopause advice to help you make informed choices
• Menopause Matters has information about the menopause, menopause symptoms and treatment options
• You can talk about your menopause experience with other women on our Health Unlocked Forum