Hormone Replacement Therapy (HRT) is a treatment available to women who have menopause-related symptoms.
If you mainly have genital symptoms such as vaginal dryness or bladder symptoms, you may choose to try a topical (vaginal) HRT treatment, also known as vaginal oestrogen cream or vaginal oestrogen tablets. However, if you have other symptoms of menopause such as hot flushes or sweats, you may want to consider HRT tablets or patches that work on the entire body.
Testing for the menopause – if you’d like to check whether you are menopausal and might be ready for HRT, you can order a home test kit.
The menopause can cause some unpleasant symptoms, including:
HRT can help – severe menopausal symptoms can interrupt with everyday life, so it is important to seek treatment, so you can carry on with your daily activities. The symptoms which women mostly complain about are hot flushes and sweating, improvements in these can help to improve their quality of life.
HRT involves replacing natural hormones – most women take a combination of the oestrogen and progestogen hormones, while women who have had a hysterectomy and have no womb can take oestrogen on its own. The primary aim of HRT is to ‘top-up’ the body’s natural supply of hormones which stop being produced during the menopause.
The two main types of HRT are:
Menopause refers to the last menstrual period in a woman’s life, and it occurs due to loss of ovarian follicular activity. This can be defined once a woman has gone for 12 months without a period.
Menopause occurs when the supply of responsive oocytes (early eggs) is exhausted. Therefore the ovaries no longer release a monthly egg, and oestrogen levels (released by the ovaries) fall.
The average age of menopause in the UK is 51. However, the period before menopause (called perimenopause), when women may experience menopausal symptoms, can begin some years before this.
Women will often note a change in their menstrual cycle to be the first sign of menopause/perimenopause.
After the last menstrual period, oestrogen production from the ovaries falls, which causes changes in levels of other hormones released from the brain. The change in hormone levels can cause a wide variety of symptoms and affect a woman’s bone and cardiovascular health.
Symptoms can be...
It can also cause poor sleep, headaches, achy joints and dry or itchy skin. The severity of symptoms will vary between women, but many report severe sleep disruption as one of the most challenging symptoms experienced.
Research is still ongoing into the effects of oestrogen deficiency and replacement on cognition. Many women do complain of poor memory or ‘brain fog’. It is uncertain if this is a direct effect or a knock on effect from other symptoms (such as poor sleep). There is ongoing research into menopause, hormone therapy, and later dementia or Parkinson’s disease.
On average, menopausal symptoms last for 4 years after your last period. Some studies suggest symptoms can start three years before this point, giving an average duration of symptoms of seven years.
Menopause itself is a point in time that refers to your last menstrual period. If we look at menopause as a symptomatic phase that passes with time, the reduction in severity and frequency of symptoms indicates the symptomatic phase is coming to an end.
There is evidence to show that smoking reduces the age of menopause, so stopping/avoiding smoking may help prevent earlier menopause. Having children and using contraception that suppresses ovulation is associated with later menopause.
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