HRT and the menopause

During the menopause, there is a sharp decrease in the amount of oestrogen (known as oestrogen depletion) and progesterone produced by the ovaries.

As well as causing irregular periods during the menopausal transition, oestrogen depletion causes the characteristic symptoms of menopause, such as hot flushes and night sweats, which are known as ‘vasomotor symptoms’. It can also cause mood changes.

How does HRT work?

For women who seek help for their menopausal symptoms, HRT (hormone replacement therapy) is the most commonly prescribed treatment. HRT works by replacing the depleted oestrogen in your body, so that you have a similar level as you had before the menopause.

If you have a womb you should be offered HRT that contains oestrogen and progestogen. This is because oestrogen-only HRT can be harmful to the lining of the womb. If you don’t have a womb you may be offered oestrogen-only HRT.

Keeping a healthy lifestyle can help to minimise the effects of the menopause:

A healthy diet: the fall in the level of oestrogen that is part of the menopause can increase the risk of heart disease and osteoporosis. Keeping your diet low in saturated fat and salt can reduce blood pressure, and food rich in calcium and vitamin D helps to strengthen bones.

Regular exercise: mood changes and anxiety often arise as a result of the menopause. Taking regular exercise helps to improve mood, and is also important for the health of your heart and bones.

Stop smoking: smoking has been shown to lead to an earlier menopause and to trigger hot flushes. Smoking also increases the risk of osteoporosis and coronary heart disease, which is one of the most common causes of death in women.

Drink within reason: alcohol increases hot flushes and increases the risk of breast cancer. Try not to drink more than 2–3 units of alcohol ‘a day’ and no more than 14 a week, and keep at least one day a week alcohol-free

Keep positive: relaxation techniques and counselling can be very helpful in coping with anxiety and low mood that can arise as a result of the menopause.

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