Menopause (HRT)

What is 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 menopause. It is 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 age 55, though the UK average for menopause is 51. If a woman stops having her periods before she is 40, it is known as premature menopause. 1% of women experience premature menopause.

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. These side effects 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 menopause symptoms.

How effective is Hormone Replacement Therapy (HRT)?

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

If deemed safe and appropriate, HRT treatment can begin as soon as the menopausal symptoms start, 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 ease your menopausal symptoms effectively, you can either try a different form or request a higher dose. Your doctor will review this to ensure you get the most beneficial outcome.

Is it safe to take Hormone Replacement Therapy (HRT) treatments?

There can be risks while using an HRT. 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, you will likely be given HRT to help ease your menopausal symptoms like night sweats, hot flushes and vaginal dryness. There is also the option of vaginal creams or vaginal moisturisers to treat the dryness and irritation.

Women who have had a hysterectomy 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 both oestrogen and progesterone in every dose, 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.

What different Hormone Replacement Therapy (HRT) treatments are available?

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 menopausal 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 HRT; others will require a combination form with 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.

Can I buy Hormone Replacement Therapy (HRT) Treatment online?

You can buy HRT treatment online after filling in a medical questionnaire at Click Pharmacy. Your answers will be assessed by our in-house prescribers, 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 your chosen treatment is the best. You can also book an appointment anytime if you need support or have questions. 

Once a prescription is issued, you will be able to buy menopause treatment online anytime and have it sent directly to your home quickly and in discreet packaging through Royal Mail 1^st class or next-day delivery service.

Does Hormone Replacement Therapy (HRT) provide immediate relief?

It can take several weeks for the benefits of HRT to be felt, and as with any medication, some women may initially experience a few side effects of HRT. 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 menopausal symptoms will start to ease, and you could experience the benefits of HRT.

What are the side effects of HRT?

Medication can cause side effects alongside the benefits required from it. Most side effects of HRT 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. In these situations, your doctor can help you find a better treatment. Side effects can include:

• Tenderness of the breasts
• Breast pain or tenderness
• Nausea and stomach pains
• Leg cramps
• Mild itching or rash
• Hair loss
• Bleeding or spotting
• Headaches
• Digestive issues, including indigestion

Rare but severe 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 of HRT.

If you experience any side effects 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, seek medical help immediately.

How do I know I need menopause treatment?

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

If you feel your menopausal 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.

How do I use HRT medications?

Hormone Replacement Therapy is used for 2 to 5 years by post-menopausal women. During the last stages of menopause, the dose is gradually lowered so you can stop taking it at the end of the treatment. You are supposed to take HRT pills or tablets daily. Patches are meant to be used every week. Several types of HRT are available; some are prescription-only, while others are OTCs. Your GP will help you determine the ideal treatment for you.

HRT contains female hormones; however, this does not mean it is a contraceptive. If you are still experiencing your menstrual cycle, you could get pregnant. In addition, note that taking HRT carries risks of certain types of cancer and blood clots. Due to this, long-term use of HRT is strongly advised against.

How does HRT work?

When a woman goes through menopause, the levels of oestrogen present in her body rapidly drop. This leads to various symptoms associated with menopause, like hot flushes, breast tenderness, night sweats and vaginal dryness. HRT simply replenishes the oestrogen levels, which helps endometrial health and reduces the intensity of the symptoms. Some HRT treatments contain progesterone, too.

Can I take HRT if I've had a hysterectomy?

Yes, you can take HRT if you have had a hysterectomy. In fact, there are various benefits to taking HRT if you have had a hysterectomy. However, taking only an oestrogen-only HRT would be best, as progesterone can lead to health complications.

It is crucial to let your GP know that you have had your uterus removed during the consultation for HRT, as that helps determine the ideal treatment for you.

What are the potential risks of HRT?

Just like most treatments, HRT treatment has its risks. However, HRT tends to present with more complications as opposed to other treatments since medications involving the endocrine system must be monitored more carefully. This is because such medications can impact various functions in your body. HRT is prescribed with a lot of attention because it essentially replaces the function of oestrogen. Oestrogen in the female body is considered to be an essential hormone, especially at an age where older women are naturally more exposed to specific health conditions, such as stroke or coronary heart disease.

The potential risks depend on how long you take HRT for. For short-term use of HRT, which can range from 2 to 5 years, it is proven that HRT has little effect. So, whilst there are risks of HRT, there is a slim chance of an individual experiencing harmful effects. Note that the doctor will only prescribe HRT if it suits you. However, to ensure you are safe while you are on HRT, you will be required to get monthly check-ups. Your GP will also prescribe you the lowest dose necessary for the least amount of time.

On the other hand, long-term HRT use can significantly increase the risk of developing ovarian cancer, breast cancer, and endometrial cancer, as well as thromboembolism. Therefore, you will not be prescribed HRT if you have a history of blood clotting conditions or even oestrogen-sensitive cancer. Additionally, to battle the risk of developing endometrial cancer, you may be prescribed progesterone in combination with oestrogen replacement treatments.

What are the benefits of treating menopause?

Menopause can disrupt the daily functioning of life. However, by treating menopause, you can get relief from the irritating symptoms of menopause, such as the reduced effect of hot flashes, night sweats, vaginal dryness, and the itching associated with oestrogen deficiency that comes with menopause.

In addition to this, you can treat osteoporosis prophylaxis by using a menopause treatment.

When oestrogen levels are kept at the natural level that the body produces before menopause hits, it helps you avoid the significant loss of bone density due to menopause.

Will I gain weight if I take HRT?

Although no evidence suggests that women gain weight because of HRT, it is vital to consider that menopause usually leads to weight gain. Due to this, it is best if you stick to a healthy eating plan and exercise regularly. This can help avoid this unhealthy weight gain.

How long will I use HRT?

In most cases, women take HRT for only two to five years. After that, they take HRT until the menopausal symptoms like vaginal dryness, night sweats, and hot flushes eventually subside. It is also advised to gradually decrease the dose of HRT instead of stopping the treatment abruptly.

However, the amount of time you will need to use HRT medications depends entirely on your condition. For example, if the symptoms of menopause, like hot flushes, night sweats and vaginal dryness, are not manageable, and you are at low risk of complications, then you may be prescribed HRT medicines for up to ten years. On the other hand, your doctor may finish your treatment options within two years or so.

HRT Patches vs HRT Tablets: Which HRT Treatment is Right for You?

HRT patches are small adhesive 'stickers' loaded with hormones. This allows HRT to be absorbed directly into the skin. You apply them to the lower abdomen. They alleviate menopausal symptoms. Each HRT patch is worn continuously throughout the week. You should change the patches twice weekly.

HRT patches come in two different types of HRT:

• Continuous combined HRT patches
• Oestrogen-only HRT patches

Similarly, HRT tablets are an oral form of HRT medication. You are supposed to take the tablets with water once every day. And they will be most effective if the tablets are taken at the same each day. You can find them in different types and strengths.

Like HRT patches, there are two types of oral HRT treatments:

• Continuous combined HRT tablets
• Oestrogen-only HRT tablets

The ideal effective treatment varies from person to person. You can use patches if they are more suitable.

How is Menopause diagnosed?

Your GP can diagnose menopause based on symptoms like hot flushes or vaginal dryness and check your medical history. If required, there may be a blood test done, too. The blood test helps check the levels of follicle-stimulating hormone (FSH) and oestrogen in the blood. During menopause, the body's FSH levels increase, and the oestrogen levels decrease.

Migraines in Menopause

Yes, there is a link between migraines and menopause. However, since the cause of migraines is still unknown, evidence suggests that hormones and fluctuating hormone levels can trigger migraine attacks.

Before and during menopause, hormone levels fluctuate in the body. This transition to menopause can cause frequent migraines and headaches.

As a result, during menopause, your migraines may get worse. They may even last longer or become more frequent. However, the opposite can happen, too. Your migraines may ease during menopause.

Signs or Perimenopause

It can be challenging to recognise the symptoms of perimenopause. Signs of perimenopause may occur in the form of:

• Menstrual irregularities
• Night sweats
• Forgetfulness
• Hot flushes
• Sleep problems
• Anxiety
• Headaches
• Mood changes
• Bone loss
• Bloating
• Vaginal dryness
• Weight gain
• Itching
• Hair loss

What are the causes of menopause?

There are four most common causes of menopause. Women who suffer from the following issues might suffer from menopause:

Decline in reproductive hormones: As you age and approach your 40s, your ovaries start making less progesterone and estrogen. Your periods become heavier or lighter, the frequency changes, and they become longer or shorter. By your 50s, the ovaries stop releasing eggs, and there are no more periods.

Ovarian insufficiency: Some women may have premature menopause resulting from ovaries failing to produce normal productive hormones and cause menopause.

Oophorectomy: Surgery that removes ovaries causes immediate menopause with severe signs and symptoms

Radiation therapy: Some cancer therapies can cause menopause, but that may not be permanent, and you may still require birth control measures.

When to see a doctor?

You need to consult your doctor when your period stops or becomes irregular. You must also visit a doctor if you notice any mood changes or physiological changes. Some women may have more difficulty during menopause than others, as each body is different.

Complications associated with menopause

There are complications associated with menopause. Some of them are as follows:

Cardiovascular Diseases: When your estrogen level declines, the chances of getting heart disease increase.

Urinary incontinence: When your uthera or tissue of the vagina loose elasticity, you may have sudden and strong urges to urinate.

Weight gain: Menopause slows down the metabolism, which may cause weight gain.

Sexual Function: Vaginal dryness from decreased moisture production and loss of elasticity may cause discomfort and pain during sexual intercourse.

Urinary Inconsistence: When the tissues of the urethra and vagina lose elasticity, you may frequently experience a sudden urge to urinate or loss of urine while laughing, lifting or coughing.

What hormonal changes happen during menopause?

During menopause, mature eggs in the ovaries diminish, and ovulation becomes irregular. Simultaneously, the production of progesterone and estrogen decreases. The significant decrease in estrogen causes symptoms of menopause.

What are the stages of menopause?

Menopause has three stages:

Perimenopause: Perimenopause is the time leading up to your menopause; periods become irregular as hormones change.

Menopause: It occurs when you complete the Perimenopause stage, the hormones don't change anymore, and your period stops for 12 months.

Postmenopause: After menopause comes postmenopause, it's time after your menopause. Women stay in postmenopause for the rest of their lives.

Lifestyle changes to manage menopause

You can make the following lifestyle changes to treat menopause:

• Exercise regularly
• Eat a balanced and healthy diet
• Practice mindful meditation
• Maintaining a healthy weight
• Getting eight hours of night sleep