What does hormone replacement therapy mean in women over 40?

HRT can be taken as tablets, patches, gels or other preparations. Oestrogen may help symptoms linked with falling hormone levels, including flushes, sleep disruption and vaginal discomfort. If you have a womb, a progestogen is generally considered with systemic oestrogen to protect the womb lining; people without a womb may have a different plan. Treatment before the usual menopause age may be discussed differently when ovarian hormone loss occurs early. HRT is not a contraceptive, so pregnancy prevention may still be needed.

Share your symptoms, menstrual pattern, blood pressure, migraine history, medicines, smoking status and personal or family history of clots, stroke, breast or womb conditions. Ask which route and dose fit your goals and whether local treatment could address vaginal symptoms. Keep follow-up appointments so benefits, side effects and bleeding patterns can be reviewed. Do not start, stop or change hormones without discussing the plan with the prescribing clinician.

Seek urgent help for chest pain, sudden breathlessness, coughing blood, one-sided weakness, a new severe headache, or a painful swollen leg. Contact your clinician about unexpected bleeding, especially if it persists, becomes heavy, starts after a period without bleeding, or appears after treatment changes. New breast, pelvic or abdominal symptoms also deserve assessment.

Which symptom is HRT intended to treat for me? Do I need oestrogen alone or a progestogen too? What form is suitable, how will bleeding be monitored, and when should we review the plan?