Hormone replacement therapy (HRT) | Health Navigator NZ

Easy-to-read medicine information about menopause hormonal therapy what it is, how to take it safely and possible side effects.

During menopause, the amount of oestrogen produced by a woman's body drops and this can cause symptoms associated with menopause such as hot flushes, night sweats, sleep problems, muscle and joint pains, mood changes, vaginal dryness and discomfort with sex. Read more aboutmenopause.

Menopause hormonal therapy (MHT) is the use of hormone therapy (tablets, patches or cream) to replace the oestrogen that your ovaries no longer make during and after menopause. It can help relieve some of the symptoms of menopause.

The main factor in deciding which MHT to use will depend of whether you still have a uterus or whetherit has been removed surgically (an operation called hysterectomy).

In addition, the choice of MHT will depend on your individual overall balance of benefit, risk, symptoms and convenience.

Image credit: MHT Australasian Menopause Society

Menopause hormonal therapy is not recommended in certain situations, such as for women who have a history of breast cancer, are at risk of heart disease, or have had a blood clot or are high risk of having a blood clot. Ask your doctor whether menopause hormonal therapy is right for you there are also other non-hormone options that can help with menopausal symptoms.

Menopause hormonal therapy is available as oestrogen alone or as oestrogen with progestogen. It is also available in different formulations such as creams, pessaries, tablets and skin patches. Some of these are used every day, while others may be used only for a few days or once or twice a week.

The following are examples ofmenopause hormonal therapy products available in New Zealand. The choice of product depends on your individual circumstances and preferences. When using MHT, use the lowest dose that eases your symptoms for the shortest time and get your treatment reviewed at least once every year to assess whether to continue it or not.

Read more about Ovestin cream and pessaries.

These patches are applied to your skin 1 or 2 times a week:

Without treatment, menopausal symptoms such as hot flushes, night sweats, sleep problems and headaches may last fora few years.Most women manage their menopause symptoms themselves, but some may need help from their doctor. MHT has been found to:

When assessing the risks associated with MHT, remember that not all women have the same risk of these effects.

For most women with moderate to severe symptoms, the benefits appear to outweigh the risks for those who are less than 10 years out from menopause or aged less than 60.

MHT can cause side effects such as breast tenderness, fluid retention, mood changes, menstrual spotting and bleeding. If you get any of these side effects, talk to your doctor as you may need a change of dose. MHT does not cause weight gain.

Contact your doctor immediately if you get any of the following symptoms while taking MHT:

If you are taking MHT and have recently had surgery or a leg injury and you are unable to walk around, contact your doctor for advice.

If you are taking MHT and decide to stop, ask your doctor how to stop safely. You may need to stop slowly over several weeks.

Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)?Report a side effect to a product

Many women consider using complementary therapies such as phytoestrogens. These oestrogen-like compounds are found in all plants but are in highest quantities in legumes, including beans and soy products. Some women find these compounds helpful, although scientific studies have found them no better than a placebo. A lack of response after 6 weeks should be seen as a reason to stop.

Similarly,scientific studies have also found the following to be no better than a placebo:black cohosh, dong quai, evening primrose oil, red clover and ginseng. Due to possible adverse effects on your liver, it is recommended that black cohosh treatment be ceased after 6 months.

All complementary therapies may have side effects and may interact with prescription medicines, so tell your doctor if you are using or planning to use these.

The following linkshave more information on MHT. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.Menopause Family Planning, New ZealandMenopause health information Australasian Menopause SocietyMenopause and HRT Patient Info, UKFacts about menopausal hormone therapyNational Institutes of Health, US

Medsafe Consumer Information Sheets:TrisequensKliogestKliovanceProgynovaEstradotClimaraPremarin

Hormone replacement therapyNZ FormularyMenopausal hormone therapy where are we now?BPAC, NZ, 2019Long term hormone therapy for perimenopausal and postmenopausal womenCochrane Database Syst Rev. 2012 Jul 11;7,Marjoribanks J, Farquhar C, Roberts H, et al.British menopause society & womens heath concern recommendations on hormone replacement therapyPanay N et al,May 2013

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Hormone replacement therapy (HRT) | Health Navigator NZ