Most hormone replacement therapy (HRT) is a combination of two female hormones, an 'oestrogen' and a 'progestogen'. Oestrogens and progestogens are natural female hormones which are used to treat women's health problems, including menopausal symptoms. Different types of oestrogen and progestogen are used in HRT products. The oestrogens used include conjugated oestrogens, estradiol, estriol and estrone. The progestogens used include medroxyprogesterone, norgestrel, drospirenone, norethisterone, dydrogesterone, and levonorgestrel. You will find the names of the oestrogen and progestogen used in your HRT on the labelling of the package. HRT is available as tablets and as patches to be applied to your skin. There are several brands for each of these types of HRT - all deliver a set dose of oestrogen and progestogen into your bloodstream.
During the menopause, or 'change', your natural female hormone levels begin to fall. HRT replaces these hormones. The oestrogen helps to relieve some of the problems associated with the menopause, such as hot flushes, night sweats and vaginal dryness. The progestogen protects the lining of your womb (uterus). Depending on the preparation you are using, you may take the progestogen daily or for only part of the month.
HRT also protects against osteoporosis, although other treatments are often preferred for this. Osteoporosis weakens your bones, making breaks and fractures more likely.
If you have had your uterus removed during surgery (a hysterectomy), then you will only need to take oestrogen HRT. Please see the separate leaflet called Oestrogen HRT for more information about this.
If you have been prescribed tablets: follow the instructions on your pack - it is usual to take one tablet every day.
Some brands may have different coloured tablets to take on certain days; other brands may contain a second tablet for you to take on certain days of the month. If you are unsure what to do, ask your pharmacist for advice.
Take the tablet at the same time of day each day. If you forget to take a dose, read the advice on the manufacturer's leaflet and follow the instructions it gives. You can take the tablets before, during or after your meals.
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
Common HRT side-effects
- Feeling or being sick
- Feeling dizzy
- Dry eyes
- Irregular menstrual bleeding
- Stomach cramps, bloating, weight changes, breast tenderness, fluid retention, itchy skin rash, acne, changes in sexual desire, mood changes, leg cramps, hair thinning.
Stop taking HRT and contact your doctor for advice straight away if you develop any of the following symptoms:
- Sudden chest pain.
- Sudden breathlessness, or if you cough up blood.
- Swelling or pain in a leg.
- An unusually severe headache.
- Yellowing of your skin or the whites of your eyes (jaundice).
If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking HRT it is important that your doctor knows:
- If you have migraine-like headaches.
- If you have any unexplained vaginal bleeding.
- If you have had breast cancer or any lumps in your breast, or if a close family member has had breast cancer.
- If you or a close family member have ever had a blood clot in the legs or lungs.
- If you have a problem with your veins (such as thrombophlebitis).
- If you have too much sugar in your blood (diabetes mellitus), epilepsy, or asthma.
- If you have liver, kidney, or gallbladder problems.
- If you have ever had depression.
- If you have high blood pressure or a heart disorder.
- If you have chest pain (angina) or if you have had a heart attack.
- If during a pregnancy you have had problems such as severe itching and blistering of your skin, yellowing of your skin or the whites of your eyes (jaundice), or any involuntary jerky movements.
- If you have a rare inherited blood disorder known as porphyria.
- If you have ever had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
The patient information leaflet (PIL) is a leaflet containing specific information about medical conditions, doses and side effects. You can download a copy of the PIL here:
Patient Info Leaflet