So what is the best HRT for me?
It depends on a number of factors, like what stage of the menopause you’re at, how sensitive you are to certain levels of hormones, and whether you prefer to take tablets or use patches, for example.
Whether or not you’ve had a total hysterectomy is also a factor, and if you have certain health conditions, that can play a big part too.
Here are your options. Our clinician can talk you through them, and recommend safe and suitable HRT treatments just for you.
Combined sequential and sequential HRT
If you’re getting menopausal symptoms and still having your period, combined sequential (or cyclical) HRT treatments are usually the recommended options. Combined HRT products like Femoston and Estalis Sequi patches are known as ‘combined’ treatments because they contain two hormones: a progesterone and an oestrogen.
With sequential HRT, you start your cycle with oestrogen only tablets (or patches) and then take a combination of oestrogen and progesterone tablets (or patches) part way through your cycle.
Continuous combined HRT
If you haven’t had a period for one year, you’re usually considered to be postmenopausal, and continuous combined HRT products like Angeliq and Estalis Continuous tend to be the suggested route. With continuous combined HRT treatments, you take a combination of oestrogen and progesterone every day, without a break (hence ‘continuous’). So they’re a little different to sequential HRT products.
Oestrogen only HRT
Oestrogen only treatments such as Estrofem and Estradot patches are normally recommended for women who have had their womb removed during a hysterectomy. Like continuous combined HRT, you typically take oestrogen every day, without a break.
Side effects of HRT may also vary from one woman to the next, so some HRT medications won’t be safe (or suitable) for women to use on this basis, while other products will be. If you’re more sensitive to oestrogen, you may be better suited to lower-dose HRT products. And if you have a particular health condition, this can mean that certain HRT products won’t be safe for you to use either.
Our clinician can identify which treatments are appropriate for you and which aren’t, and make recommendations based on your medical background.
What HRT alternatives are there?
There’s a prescription HRT medicine called Tibolone (also branded as Livial, Livilan and Xyvial) that’s used to relieve menopausal symptoms and as a preventative treatment for osteoporosis. Tibolone is the active ingredient, so it’s a bit different to other forms of HRT, which contain oestrogen and progesterone (or just oestrogen).
It can help to ease symptoms like hot flushes, reduced sex drive and low mood, but research has suggested that Tibolone may be less effective than combined HRT. It’s also only a suitable option for women who are postmenopausal (so women who had their last period over a year ago).
Tibolone can produce side effects, including breast pain, vaginal discharge, pain in the pelvis, itching and abdominal pain.
The slightly increased risks of breast cancer and stroke that HRT carry are similar with Tibolone.
Clonidine is another prescription treatment that’s sometimes used to help tackle symptoms like flushing and night sweats. It’s a tablet that you take two or three times a day, and it has no effect on hormone levels, so there’s no increased risk of breast cancer for example. Studies suggest that it only has a small impact on easing flushing and night sweats though, and it can have unpleasant side effects too. Clonidine is a blood-pressure medication. It’s not licensed for treating menopause symptoms, but doctors might prescribe it to you ‘off-label’ if they think it’ll be a safe and suitable treatment for you.