Menopause and Hormone Replacement Therapy (HRT)

When a woman ceases to have her regular monthly cycle she also stops being able to conceive and this is known as the menopause. It is the time when women stop producing as high a level of oestrogen and the declining levels, often occurring over a number of years, cause periods to become lighter and/or less frequent as the ovaries stop producing an egg each month. It can begin from the age of 45 and is usually completed by the age of 55 though the UK average for the menopause is 51. If a woman stops having her periods before she is 40 it is known as premature menopause and about 1% of women will experience this.

Symptoms of the menopause can vary in severity from woman to woman, but they range from hot flushes and night sweats, to vaginal dryness, anxiety and insomnia. It is these side effects which cause many women to turn to hormone replacement therapy, or HRT, for help through this time.

Oestrogen, the core ingredient in HRT treatments, helps with several bodily functions including bone strength, the temperature of the skin and the production of the natural discharge which enables the vagina to remain moist and it is used to effectively replace this declining hormone and relieve these difficult symptoms.

HRT is the first line in defence against the sometimes life-affecting symptoms which some women experience whilst going through the menopause. Doctors ensure this form of treatment is safe for a patient by going through some questions regarding current health, the symptoms being experienced, medications being taken for other health issues, amongst others.

If deemed safe and appropriate, HRT treatment can begin as soon as the menopausal symptoms begin and your doctor will help you to make an informed choice on which will be the most effective for you. Most treatments should be taken at the lowest effective dosage so you will be given a lower dose initially for up to 3 months. If you have not found your treatment to effectively ease your symptoms then you can either try a different form of it after this time or request a higher dose. This will be reviewed by your doctor to ensure you get the most beneficial outcome.

Women for whom it would not be considered safe to use an HRT would not be prescribed it and there are a number of reasons this may occur including:

• a family history of breast, womb or endometrium cancer
• a personal history of breast, womb or endometrium cancer
• uncontrolled high blood pressure
• liver disease
• pregnancy

If you have not experienced these health issues then you are likely to be given HRT to help you ease your menopausal symptoms.

For women who have had a hysterectomy, they can take an oestrogen-only form of HRT but for those who have not, an oestrogen-only dose could increase the risk of cancer including cancer of the womb. The combination form of HRT includes progesterone along with the oestrogen and it works to counteract the stimulating effects of the oestrogen and stop the excess growth of the womb lining from which cancer can develop. This will all be discussed with you before you begin any treatment and if you have any questions you can book a free appointment with a doctor at Click Pharmacy.

HRT can come in several forms making it easily accessible for all women. It can be taken as a daily pill, a patch, a gel, cream, pessary or ring.

Some forms need to be taken daily to ensure the levels of the depleted hormone stay steady and symptoms do not reoccur whereas others, such as the patch, absorb slowly over the course of a few days. Some women can take the oestrogen-only form and others will require a combination form which has both oestrogen and progesterone in every dose.

Your doctor will be able to advise you on the best HRT treatment for you before you begin taking it

You can purchase your HRT treatment online after filling in a medical questionnaire. Your answers will be assessed by our in-house doctors who will be able to ensure you are prescribed the most effective form of treatment for your situation. This will be based on different factors including, but not limited to, your age, the severity of your symptoms as well as other health issues you have experienced previously or are currently suffering from. You may be offered a free and confidential online appointment to discuss your options if the doctor does not feel the treatment you have chosen is the best one. You can also book an appointment anytime if you need support or have questions.

It can take several weeks for the benefits of HRT to be felt and as with any medication, some women may experience a few side effects in the beginning. Women will mostly be encouraged to give their new treatment at least 12 weeks before looking to change their medication or dose.

Once your oestrogen hormone levels have begun to increase again, your symptoms will begin to ease.

Medication can cause side effects alongside the benefits required from it. Most side effects will be mild and should not cause a woman to stop using her treatment, whereas others may struggle with their side effects whilst waiting for their menopausal symptoms to ease, and in these situations, your doctor can help you find a better treatment.

Side effects can include:

• tenderness of the breasts
• nausea and stomach pains
• bleeding or spotting
• headaches
• digestive issues including indigestion

Rare but serious side effects can include blood clots and cancer including breast or womb cancer, though it is important to remember that HRT will only be prescribed where the benefits are seen to outweigh any risks.

If you experience any side effects which you are concerned about, contact your GP or Click Pharmacy doctor right away.

If you experience a severe reaction to the medication such as an allergy response including swelling of the lips or throat, then seek medical help right away.

Some women prefer not to use HRT and it is a choice whether you want to take it or not. it depends on how badly you suffer with symptoms including reduced sex drive, hot flushes, anxiety and mood swings, as well as vaginal dryness and pain from sex.

If you feel your symptoms are severely affecting your life then you can book an appointment with a doctor at Click Pharmacy or your GP at any time to find a way to relieve the issues.