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Hormone Replacement Thereapy (HRT)

For a more comfortable menopause journey

Hormone Replacement Therapy (HRT) is a medication that helps treat the symptoms of perimenopause and menopause. During this phase, the levels of oestrogen in our bodies fluctuate and decrease, causing various discomforts.

The good news is that HRT can bring several benefits to make this transition easier for you. It helps ease menopausal symptoms like hot flashes, mood swings, and night sweats. Moreover, if you start HRT before the age of 60, it can provide long-term health advantages as well!

For instance, HRT can protect your bone health, reducing the risk of fractures and osteoporosis. It also looks after your heart by reducing plaque buildup, decreasing blood pressure, and improving heart function. Additionally, HRT helps manage fats and glucose in your blood, lowering the risk of stroke and promoting overall cardiovascular health.

It’s important to know that there are different types of HRT available, and your specialist will discuss the right one for you based upon your individual needs.

Types of HRT

Find the right type of HRT for you.

When choosing the right type of HRT for you, several factors come into play, including your susceptibility to certain illnesses based on your family history and your specific symptoms. It’s important to have a discussion with your clinician to determine the most suitable option.

Regarding customising your HRT dosage and regimen, there are options available. For instance, if you struggle with daily pill-taking, alternative methods like patches or vaginal delivery systems can provide continuous hormone absorption. Additionally, cyclical combined HRT allows for a break from progestogen for a specific period of time, which can be considered based on your symptoms and preferences.

Ultimately, your clinician will provide personalised guidance to help you select the most appropriate type of HRT based on your individual needs, medical history, and preferences. They will consider both the benefits and potential risks associated with each form of HRT to ensure the best possible outcomes for you.

Pros & Cons

It’s important to note that the risks and benefits of HRT can vary depending on factors such as age, personal medical history, family history, and the specific type, dose, and duration of HRT used. Regular follow-up appointments with a healthcare provider are crucial to monitor the ongoing benefits and any potential risks associated with HRT.

Relief from menopausal symptoms

Hormone Replacement Therapy (HRT) can effectively help with common menopause issues like hot flashes, night sweats, dryness, and mood swings, making you feel better overall.

Long-term health benefits

If you start HRT before age 60, it can also protect your bones from getting weaker (osteoporosis) and lower your risk of fractures. It might even be good for your heart by reducing plaque, lowering blood pressure, and improving heart function.

Personalised symptom management

Different types of HRT can target specific symptoms you have, so your treatment plan will be tailored to your needs and preferences.

Increased risk of blood clots

Some forms of HRT, particularly oral tablets, may slightly increase the risk of blood clots, deep vein thrombosis, and pulmonary embolism.

Cardiovascular risks

The use of HRT, especially in older women or those with pre-existing cardiovascular conditions, may slightly increase the risk of stroke, heart disease, and other cardiovascular events.

Other considerations

HRT may have other potential side effects, such as breast tenderness, bloating, nausea, headache, mood changes, and vaginal bleeding. These side effects are typically temporary and subside with time.

The Process

Personalising Your HRT Approach 

When it comes to Hormone Replacement Therapy (HRT), personalization is key to ensuring optimal outcomes and symptom relief tailored to your unique needs. By working closely with a healthcare provider specialising in menopause management, you can create a treatment plan that addresses your specific symptoms, preferences, and lifestyle factors. Here are important considerations to guide the personalization of your HRT approach:

Menopause consultation

A consultation with a specialist is crucial in determining the most suitable HRT regimen for you. During this consultation, your medical history, current symptoms, family history, and overall health will be evaluated. This information will help your specialist create a treatment plan that aligns with your specific needs and goals.

Individual symptom assessment

Menopause symptoms can vary significantly among individuals. By discussing your specific symptoms in detail with your specialist, they can gain a better understanding of the challenges you’re facing. This information will guide them in selecting the most appropriate HRT option and dosage to target and alleviate your specific symptoms effectively.

Treatment preferences

HRT comes in various forms, including pills, patches, gels, creams, and vaginal preparations. Your treatment preference and lifestyle factors will be taken into account when choosing the most suitable option. For instance, if you prefer a non-oral route of administration or have difficulty adhering to a specific regimen, alternative options can be explored. Openly sharing your preferences with your specialist will help create a treatment plan that works best for you.

Hormone dosage adjustment

HRT dosages can be adjusted to achieve the desired symptom relief. Your specialist will closely monitor your response to the initial dosage and make necessary adjustments as needed. This personalised approach ensures that you receive the optimal hormone dosage for your individual needs, striking the right balance between symptom control and minimising potential side effects.

Regular follow-up and feedback

Regular follow-up appointments with your specialist are essential throughout your HRT journey. These appointments allow for ongoing evaluation of symptom management, assessment of treatment effectiveness, and monitoring for any potential side effects. Providing feedback on your symptoms and experiences will help your specialist fine-tune your treatment plan for maximum benefit.

Shared decision-making

Your preferences, concerns, and input play a significant role in the decision-making process. Shared decision-making with your specialist ensures that your treatment plan aligns with your goals, values, and comfort level. Don’t hesitate to ask questions, seek clarification, and actively participate in the treatment decisions. This collaborative approach empowers you to make informed choices and enhances the effectiveness of your HRT experience.


Your questions answered

Eligibility and Alternatives

Who is a suitable candidate for HRT?

Anyone experiencing uncomfortable or unmanageable menopausal symptoms.

Are there any age restrictions for starting HRT?

No, but a detailed consultation with a clinician is advised after the age of 60 due to changing risks versus benefits.

Are there any contraindications or medical conditions that can not use HRT?

Yes, the following conditions are contraindications for HRT use:

  • Current, past, or suspected breast cancer
  • Known or suspected oestrogen-dependent cancer
  • Undiagnosed vaginal bleeding
  • Untreated endometrial hyperplasia
  • Previous spontaneous or current venous thromboembolism (deep vein thrombosis or pulmonary embolism), unless already using anticoagulant treatment
  • Active or recent arterial thromboembolic disease (e.g., angina or myocardial infarction)
  • Active liver disease with abnormal liver function tests
  • Thrombophilic disorder (blood clotting disorders)
  • Pregnancy

Caution is advised when considering HRT for individuals with the following conditions:

  • Porphyria cutanea tarda
  • Diabetes mellitus (increased risk of heart disease)
  • Factors predisposing to venous thromboembolism (e.g., obesity, smoking, immobility, family history)
  • History of endometrial hyperplasia
  • Migraine and migraine-like headaches
  • Increased risk of breast cancer

Oestrogen-only HRT may slightly increase the risk of womb or ovarian cancer when used with progesterone/progestogen. HRT tablets may increase the risk of stroke, liver problems, or heart disease, although the risk is extremely low.

It is important to inform your clinician about any medications you are taking to assess their potential impact on HRT effectiveness.

Can HRT be used during perimenopause or after menopause?

Yes, HRT can be beneficial for treating perimenopausal symptoms. It can also continue to alleviate symptoms in postmenopausal individuals and help prevent osteoporosis.

Are there alternatives to HRT for managing menopause symptoms?

Yes, alternatives include:

  • Making healthy lifestyle choices such as exercising, eating a balanced diet, and reducing alcohol/caffeine consumption and smoking.
  • Wearing breathable cotton clothing, especially at night, to manage hot flushes.
  • Using vaginal moisturisers and lubricants to alleviate vaginal dryness and discomfort.
  • Considering progesterone-only contraception methods (e.g., Mirena, implant, injectable, or pill) to manage heavy periods during perimenopause.
  • Combined hormonal contraception may also be used for individuals under 50 without contraindications, as it provides contraception and symptom relief.
  • Tibolone, a progestogen, can treat menopausal symptoms but has not been extensively researched like other forms of HRT.
  • Clonidine, a non-hormonal vaso-dilator, can be used to treat night sweats and hot flushes.
  • Antidepressants may be prescribed for symptoms such as anxiety, low mood, and night sweats but should not be used as a replacement for HRT in individuals without contraindications.

Effectiveness and Expectations

How soon can I expect to see improvements in my symptoms with HRT?

While everyone’s experience may vary, most individuals can typically expect to feel some benefits within a few weeks of starting HRT. Full improvements may be noticed within a period of up to 3 months. However, if you do not observe any improvements, it may be worth considering switching the method of treatment.

Can HRT help with all menopause symptoms?

Different types of HRT are more effective in managing specific symptoms. If you are still experiencing symptoms at an uncomfortable level, it might be worth exploring alternative treatment methods to see if they provide better relief.

Will HRT completely eliminate my symptoms?

HRT is primarily aimed at easing and reducing symptoms associated with menopause. While it can significantly alleviate symptoms for many individuals, complete elimination of symptoms is not guaranteed. However, in some fortunate cases, symptoms may become imperceptible.

Can HRT prevent long-term health complications associated with menopause?

Studies have suggested that HRT can effectively help prevent certain long-term health complications associated with menopause. It has been found to be beneficial in preventing osteoporosis (loss of bone density) and reducing the risk of cardiovascular disease.

Monitoring, Follow-Up and Stopping HRT

How often should I visit my healthcare provider while on HRT?

Each patient should be assessed individually, but it is generally recommended to have a review after the first three months and then annually once your symptoms are stable.

Will I need regular hormonal testing while on HRT?

In most cases, regular hormone level checks or tests are not necessary. However, in certain circumstances, such as concerns about hormone absorption, the clinician may need to repeat blood tests.

What signs or symptoms should I watch for while on HRT?

It is important to be aware of the following signs or symptoms while on HRT:

  • Pain, redness, or swelling in the legs, as these could indicate blood clots.
  • Breathlessness, chest pain, or coughing up blood, as these could be warning signs of serious conditions such as blood clots.
  • Weight gain, headaches, memory loss, mood swings, or depression should not be tolerated and should be discussed with your healthcare provider.

Can adjustments be made to my HRT regimen if needed?

Yes, adjustments to your HRT regimen can be made if needed. It may be necessary to try different types of medication to find the one that feels right for you and fits well with your preferences and current lifestyle. Your healthcare provider can guide you in making appropriate adjustments.

Can I stop taking HRT abruptly?

No, you should not stop HRT abruptly. Abruptly discontinuing HRT can lead to sudden fluctuations in hormone levels, potentially causing a return of symptoms, which may even be worse than before. It is important to gradually reduce the dose over time until you stop completely. Your healthcare provider can guide you through this process and provide information on what to expect.

How should I gradually discontinue HRT if desired?

The approach to gradually discontinuing HRT may vary depending on the type of treatment you are receiving. For example, if you are taking pills, it is important not to miss doses between days, as this can cause abrupt hormone fluctuations. Your healthcare provider can help you by prescribing a lower dose or adjusting your regimen over a period of 3-6 months.

What happens after I stop HRT? Will my symptoms return?

After stopping HRT, some individuals may experience a return of symptoms, while others may not notice any negative changes. If symptoms do return, it is usually temporary and they should gradually subside over a few months. However, everyone’s experience can be different. If you have any concerns or worries, it is advisable to discuss them with your healthcare provider, who can provide guidance and support during this transition period.

Next Steps

Understand your menopause

Manage your menopause



Understanding your menopause

Our specialist information on Menopause is designed to help you better understand the changes your body is going through and to help you make the right decisions when it comes to managing it.


A clear pricing structure

In the event that you are hoping for your insurance to cover the cost of your visit, we request you to contact them before booking an appointment. Furthermore, the consultation fee is not incuded in the tests/procedures/medications.


In Person (45 minutes)£150

Telephone/Video (45 minutes)£150

Hormonal testing for managing menopause

Comprehensive Menopause Screen (Oestradiol, Progesterone, Testosterone, SHBG, FSH, LH, TSH, T4, T3, Vitamin D)£250

Essential Sex Hormone Screen (Oestradiol, Progesterone, Testosterone, SHBG, FSH, LH)£150

Testosterone and Hormone Balance Screen (Testosterone, SHBG)£100

Comprehensive Hormone and Thyroid Screen (Oestradiol, Testosterone, SHBG, TSH, T4, T3)£150

Thyroid Function Screen (TSH, T4, T3)£100

Hormonal Replacement Therapy (HRT)

Initial Private Prescription (inc. in consultation)

Repeat Private Prescription£30

Mirena Coil

Mirena Coil Fitting (45 minutes)£450

Menopause consultation + Mirena Coil Fitting (1.5 hours)£600

Mirena Coil Removal (Routine)£150

Mirena Coil Removal (Ultrasound Guided)£350

Mirena Coil Check (Routine)£60

Mirena Coil Check (Ultrasound Guided)£150