Question asked by: 
Date asked: 
Jan 2018
I’m considering taking Hormone Replacement Therapy (HRT). Please can you explain to me how it works, and what the benefits and side effects of taking it are?
Many women find HRT a huge help, but it’s not for everyone.
Response by Dr Vicki Barber, GP

If your tumour is not oestrogen dependant, you may be able to take HRT if you have menopausal symptoms. Your oncologist will discuss this with you.

If you are under 45, it’s considered a premature menopause and you would be offered HRT if possible.

Risks of a premature menopause include:

  • osteoporosis (bone thinning and risk of fractures)
  • heart disease

HRT is normally recommended until the average age of the natural menopause. In women over the age of 50, it can increase the risk of breast cancer or heart disease in long term use. Though this does depend on which hormones are in your HRT.

If you’re having troublesome menopausal symptoms but you’re over 45, you may still have the option of taking HRT.

The type of HRT you’ll be given depends on your personal choice, your previous medical history and whether you still have a uterus or not. There are patches, skin gels and tablets. There is also localised oestrogen for the vagina. Women often try different types before they settle on their preferred one.

The dose is usually the lowest possible, dependant on your symptoms, but can be modified to reduce side effects, or increased for better control.

Side effects of HRT

These depend on the type: patches and gels can cause skin irritation; all types can cause nausea, bloating, weight changes and breast tenderness.

Your doctor will discuss the options and possible side effects with you.

HRT is associated with a small increased risk of blood clots (deep vein thrombosis or pulmonary embolism), strokes and breast cancer. These risks rise with the length of time that you take HRT and how old you were when you started on it. It is normally stopped after five to 10 years. If you’re under 60, the benefits of being able to control symptoms are considered to outweigh the risks.

Many women find HRT a huge help, but it’s not for everyone.