Menopause and Hormone Replacement Therapy (HRT) Information

Introduction to Menopause

Menopause marks the natural biological process when a woman’s menstrual cycles end, typically occurring between ages 45 and 55. It happens due to the ovaries reducing hormone production—primarily oestrogen and progesterone. This reduction can lead to various physical and emotional symptoms.

What is Perimenopause?
Perimenopause is the transitional phase leading up to menopause when women might experience symptoms like irregular periods, hot flashes, and mood changes.

Early Menopause
Early or premature menopause occurs when symptoms start before the age of 40. Around 5% of women experience early menopause, which can have additional health implications.

Diagnosing Menopause
Menopause is typically diagnosed based on age and symptoms. In some cases, blood tests, like FSH (Follicle Stimulating Hormone), may be used, especially if symptoms occur earlier than expected.

Menopausal Symptoms Checklist

The following are common symptoms of menopause and perimenopause:

• Irregular periods or cessation of periods
• Hot flushes and night sweats
• Sleep disturbances
• Mood changes, including anxiety and irritability
• Brain fog
• Vaginal dryness or discomfort during intercourse
• Loss of libido
• Recurrent urinary tract infections
• Joint and muscle aches

Management options for Menopause

 When managing menopause symptoms without HRT , patients can consider several NICE-recommended approaches.

1. Cognitive Behavioral Therapy (CBT): Patients can engage with a mental health professional for CBT, which helps manage mood swings, anxiety, and hot flashes by focusing on coping strategies and mindset shifts.

2. Lifestyle Adjustments: Regular physical activity, such as walking or yoga, is beneficial for overall well-being and can reduce menopausal symptoms.

3. Dietary Changes: Maintaining a balanced diet rich in calcium and vitamin D is key for bone health. Consulting a local nutritionist might be helpful.

4. Local Menopause Support Groups: Connecting with local support groups or clinics in Hampshire can provide additional resources, shared experiences, and guidance on non-HRT options. 

or - consider Hormone Replacement Therapy (HRT)

What is HRT?

Hormone Replacement Therapy (HRT) is a treatment that replaces oestrogen and progesterone, the hormones whose levels decrease during menopause. HRT is primarily used to relieve symptoms such as hot flushes, night sweats, sleep disturbances, and mood changes.

HRT Medication options

HRT comes in different forms, each with its benefits and potential side effects. Your doctor can help determine the best option for you. These include different methods of delivery of both oestrogen and progestogens.

• Transdermal Patch: A patch applied to the skin that releases hormones or a spray
• Oestrogen Gel: A gel that you apply to your skin.
• Oral Tablets: Taken by mouth.

Risks and Benefits of HRT

HRT can provide significant relief from menopausal symptoms, but it is important to weigh the benefits against potential risks. The benefits of HRT include:

• Relief from hot flashes and night sweats
• Improvement in mood and mental clarity
• Better sleep quality
• Reduced risk of osteoporosis and fractures

However, there are risks associated with HRT, such as:

• Increased risk of blood clots (VTE): This is particularly relevant for women who smoke or are over 35.
• Breast cancer: Some studies show that long-term use of combined oestrogen and progesterone may slightly increase breast cancer risk. 
   Click to Download PDF showing Breast cancer risk and HRT
• Stroke and heart disease: Especially in women over 60 or those with existing cardiovascular risk factors.

HRT Risk Assessment

Before starting HRT, your healthcare provider will assess whether it’s appropriate for you. The assessment includes questions regarding:

• Personal and family history of breast or endometrial cancer
• History of blood clots, stroke, or heart disease
• Liver disease or other medical conditions

HRT Reviews

Once you start HRT, regular follow-up appointments are important.

After starting you will have a 3 month review and then you should have an annual review with your healthcare provider to monitor the effectiveness of the treatment and manage any potential risks. This ensures that your HRT regimen remains the most appropriate option as your needs change.

Useful Resources for More Information:

For further details on menopause, HRT options, and evidence-based guidelines, visit the following trusted resources:

• Menopause Matters Menopause Matters Website
  Provides comprehensive information about menopause and HRT treatment options.

Get Started with Your Menopause Consultation

1. Complete an HRT eConsult to send to your surgery 
2. Discuss HRT and other treatment options during your consultation with the pharmacist or GP.

Common Questions About HRT

Do I always need HRT during menopause?
Not everyone requires HRT. Many women can manage symptoms with lifestyle changes, such as diet and exercise. Your doctor will help you decide if HRT is the right option.

What if I have a history of breast cancer in my family?
If you have a family history of breast cancer, it’s important to discuss this with your doctor, as this may influence the suitability of HRT. Your doctor may recommend a non-hormonal approach to symptom management.

How long can I take HRT?
The duration of HRT will vary based on individual health, preferences, and risk factors. Regular reviews are essential to determine how long HRT should be continued.

Navigating the menopause can be challenging, but with the right support, it can also be a time of empowerment. Ensure you work closely with your healthcare provider to find the best treatment options for your needs.