HRT is a safe and effective treatment for most going through menopause and perimenopause. Your GP will discuss any risks with you.
HRT involves using oestrogen to replace your body's own levels around the time of the menopause.
There are different types and doses of HRT. Using the right dose and type usually means your symptoms improve.
Oestrogen comes as:
- skin patches
- a gel or spray to put on the skin
If you have a womb (uterus) you also need to take progesterone to protect your womb lining from the effects of oestrogen. Taking oestrogen and progesterone is called combined HRT.
Progesterone comes as:
- patches, as part of a combined patch with oestrogen
- IUS (intrauterine system, or coil)
If you have low sex drive because of menopause and HRT does not improve it, you may be offered testosterone.
What are the benefits of HRT?
The main benefit of HRT is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.
Hot flushes or night sweats often improve within a few weeks. Other symptoms like mood changes and vaginal dryness can take a few months to improve.
Taking HRT can also reduce your risk of hormone-related health problems including osteoporosis and heart disease.
Complementary and alternative therapies
Complementary and alternative treatments, such as herbal remedies and compounded bioidentical ("natural") hormones, are not recommended for symptoms of the menopause or perimenopause.
This is because it's not clear how safe and effective they are.
Red clover and black cohosh are herbal remedies but there is no strong evidence that they work.
Some complementary and alternative therapies can also interact with other medicines and cause side effects.
Ask your GP or pharmacist for advice if you're thinking about using a complementary therapy.
Non hormone treatments
There are non-hormone treatments if your symptoms are having a big impact on your life and you cannot, or choose not to, have HRT.
Hot flushes and night sweats
There are some medicines that can help with hot flushes and night sweats.
- a blood pressure medicine called Clonidine
- an epilepsy medicine called Gabapentin
Talk with a GP about these medicines and their side effects, and if they might be suitable for you.
Antidepressants can help with mood symptoms if you've been diagnosed with depression or anxiety.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy which can help with:
- low mood and anxiety caused by menopause and perimenopause
- some physical symptoms like hot flushes and joint pain
You can get NHS talking therapy without going to a GP first.
What can I do to look after my mental health?
Eating healthy, balanced meals and snacks regularly will help keep your blood sugar stable.
Make sure you aren’t drinking too much alcohol and avoid caffeine if you find it makes you anxious, affects your sleep or triggers your hot flushes.
You should aim for 7-8 hours of sleep each night. If you suffer from hot flushes in the night or night sweats, then you should sleep naked or wear cotton nightclothes. Consider investing in a cold gel pack or cooling pillow.
Avoid hot drinks before bed and take sips of cold water instead.
Ensure your bedroom is comfortably cool. Keep the window slightly open and/or a fan near your bed. Switch off electronic devices/screens at least one hour before bed and/or consider wearing blue-light blocking glasses in the evening. Avoid alcohol before bed; not only does it reduce good-quality sleep, it is an endocrine (hormone) disrupter and can affect the efficacy of medication, including HRT.
Get some exercise if you can, as it will lift your mood.
Try activities like yoga, Pilates or walking to help you to de-stress.
Try to do things that you find relaxing, like reading, going for a walk or practising mindfulness.