Choosing how to take HRT may be a matter of personal preference unless there is a health reason why you should take a particular form. It is important to discuss your medical history and the different types of HRT with your doctor. Here are the main options:. Tablets: one of the easiest and most common ways of taking HRT either combined or estrogen-only is in tablet form.
You simply need to remember to take your pill once a day. Try it if…you want a form of HRT that is simple and easy to take, and you do not have a history of heart disease, stroke or liver problems as the tablet-form can slightly increase your risk of these conditions, although the risk is extremely low.
Skin patches: You stick these patches on your skin and replace them every few days. Both combined and estrogen-only patches are available.
Try it if…you think you would prefer this method to tablets or gels or you have a history of a clot, diabetes, heart or liver problems as this form of estrogen has fewer risks compared with taking tablets. Patches are easy to use: you peel the backing off the patch and stick it to a hairless area of skin such as your upper arm, hip or upper leg. It delivers a constant absorption of hormones and does not affect the liver or increase your risk of a clot.
Estrogen gel: This is a popular form of HRT which you apply to your skin once a day using a pump-action bottle. Like the patches, the HRT is absorbed into the skin. Try it if…you do not want to have to change patches two or three times a week or you think patches might irritate your skin.
You may also be able to use the gel if you have a history of heart problems, diabetes and clots as this form of HRT is associated with fewer risks than the tablet form you should discuss the pros and cons in these situations with your healthcare professional. Tibolone, like other continuous therapies, is normally prescribed at least 12 months after the last menstrual period, so many women switch to these continuous types after taking a sequential HRT. Tibolone has also been shown to be particularly useful in women who are known to have endometriosis and fibroids as it does not appear to stimulate these conditions.
As with any drug, there are known short-term and usually mild side effects from HRT which may trouble some women, especially in the first few months of use. These may include breast tenderness, leg cramps, nausea, bloatedness, irritability and depression. These side effects are related to oestrogen or progestogen, and may be overcome by a change of dosage, ingredients or route in the HRT prescribed. Irregular bleeding or spotting can occur during the first months of taking continuous combined HRT or Tibolone, and is not a cause for alarm.
However, you should consult your doctor if you get heavy rather than light bleeding, if it lasts for more than six months, or if bleeding starts suddenly after some time without bleeding.
Irregular bleeding may sometimes be improved by changing the type or route of HRT. Some women do not wish to use, or cannot take, systemic HRT in any form which raises hormone levels throughout the body, but they still appreciate the relief of symptoms such as dry vagina and urinary problems. In this case, oestrogens can be given locally to the vagina in the form of a low dose cream, tablet or ring.
These preparations raise local hormone levels but do not affect the whole body. Progestogen is not needed, since these local doses of oestrogen do not affect the endometrium. You may be able to manage menopausal hot flashes with healthy-lifestyle approaches such as keeping cool, limiting caffeinated beverages and alcohol, and practicing paced relaxed breathing or other relaxation techniques.
There are also several nonhormone prescription medications that may help relieve hot flashes. For vaginal concerns such as dryness or painful intercourse, a vaginal moisturizer or lubricant may provide relief. You might also ask your doctor about the prescription medication ospemifene Osphena , which may help with episodes of painful intercourse. To determine if hormone therapy is a good treatment option for you, talk to your doctor about your individual symptoms and health risks.
Be sure to keep the conversation going throughout your menopausal years. As researchers learn more about hormone therapy and other menopausal treatments, recommendations may change. If you continue to have bothersome menopausal symptoms, review treatment options with your doctor on a regular basis.
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Several remedies such as bioidentical hormones are claimed to help with menopausal symptoms, but these are not recommended because it's not clear how safe and effective they are.
Bioidentical hormones are not the same as body identical hormones. Body identical hormones, or micronised progesterone, can be prescribed to treat menopausal symptoms. Read more about alternatives to HRT. Page last reviewed: 09 September Next review due: 09 September Benefits of HRT The main benefit of HRT is that it can help relieve most of the menopausal symptoms , such as: hot flushes night sweats mood swings vaginal dryness reduced sex drive Many of these symptoms pass after a few years, but they can be unpleasant and taking HRT can offer relief for many women.
But HRT may not be suitable if you: have a history of breast cancer , ovarian cancer or womb cancer have a history of blood clots have untreated high blood pressure — your blood pressure will need to be controlled before you can start HRT have liver disease are pregnant — it's still possible to get pregnant while taking HRT, so you should use contraception until 2 years after your last period if you're under 50, or for 1 year after the age of 50 In these circumstances, alternatives to HRT may be recommended instead.
There are different: HRT hormones — most women take a combination of the hormones oestrogen and progestogen, although women who do not have a womb can take oestrogen on its own ways of taking HRT — including tablets, skin patches, gels and vaginal creams, pessaries or rings HRT treatment plans — HRT medicine may be taken without stopping, or used in cycles where you take oestrogen without stopping but only take progestogen every few weeks A GP can give you advice to help you choose which type is best for you.
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