What should you know about HRT after menopause?

Hormone replacement therapy replaces some oestrogen, and may include a progestogen when the womb is present. It can help symptoms such as hot flushes, night sweats, vaginal dryness and sleep or mood disruption linked with menopause. Local vaginal treatment and whole-body treatment are different options, with different purposes and absorption.

HRT is not suitable in the same way for everyone. A clinician considers unexplained bleeding, previous blood clots, certain cancers, liver disease, migraine patterns and cardiovascular risk before recommending it. Treatment may be tablets, patches, gels, sprays or local preparations, depending on the symptoms and medical context.

Arrange a review to discuss which symptoms affect daily life, whether you still have a womb, your personal and family history, and medicines you already use. Use the prescribed product consistently and return for review if symptoms remain troublesome or side effects appear. Do not stop or change HRT abruptly without advice, because symptoms can return and the regimen may need adjustment.

Keep breast and cervical screening appointments appropriate for your age and health. Report any new bleeding after menopause, even if it is light, so it can be assessed.

Seek urgent help for chest pain, sudden breathlessness, coughing blood, one-sided leg swelling, facial weakness or trouble speaking while using HRT. Contact your clinician promptly for heavy or persistent bleeding, a new breast change, severe headache or jaundice. A clinician can distinguish expected early effects from symptoms needing investigation.

Ask which symptoms HRT is intended to treat, whether you need oestrogen with progestogen, which route suits you, how bleeding will be monitored, when to review the plan, and what alternatives are available.