Understanding Hormone Replacement Therapy (HRT)
What is Hormone Replacement Therapy (HRT)?
Perimenopause and menopause can bring a mix of changes – from hot flushes and night sweats to low mood, vaginal dryness and a reduced interest in sex. These symptoms are caused by falling oestrogen levels, which affect everything from energy and sleep to confidence and comfort.
HRT replaces these hormones to restore balance. It’s the most effective treatment for easing menopause symptoms and helping you feel more like yourself again.
There’s no single type of HRT that suits everyone. It comes in many forms – tablets, patches, gels, and sprays – and in over 50 different combinations. The best choice depends on your stage of menopause, whether you still have a uterus, your medical history, and what feels right for you.
What hormones are replaced?
Oestrogen
Oestrogen is the main hormone replaced in HRT. The type most commonly used is oestradiol, a form made from yams that’s identical to the oestrogen produced by your body – often called body-identical.
It can be taken as a tablet or absorbed through the skin using a patch, gel, or spray. For vaginal dryness or urinary symptoms, local oestrogen (in a cream, tablet, or ring) can be applied directly where it’s needed.
Progesterone
If you still have your uterus, you’ll also need progesterone (or a similar hormone called a progestogen) alongside oestrogen. This protects the womb lining and keeps it from thickening. The safest and most natural option is micronised progesterone (brand name Utrogestan), which is body-identical and can be taken as a capsule by mouth or inserted vaginally.
Another option is the Mirena coil, which releases small amounts of progesterone into the womb for up to five years — providing both protection and contraception.
Testosterone
Some women continue to feel fatigued, lose interest in sex, or struggle with focus even after starting oestrogen. In these cases, adding a small amount of testosterone can help restore energy, concentration, and sexual wellbeing.
Benefits of HRT
Many women notice a real improvement in how they feel once their hormones are balanced again. HRT can ease the symptoms of menopause, support long-term health and help you feel more like yourself – physically, mentally and emotionally.
Hot flushes & night sweat relief
HRT is the most effective way to reduce hot flushes and night sweats, helping you feel more comfortable and sleep better.
Better mood & energy
By restoring hormone balance, HRT can lift mood, reduce anxiety, and improve overall energy levels and focus.
Improved vaginal & urinary health
Oestrogen replacement can ease vaginal dryness, discomfort, and urinary symptoms, improving comfort and confidence.
Bone & heart protection
HRT can help protect against osteoporosis and may lower the risk of heart disease when started early in menopause.
When should I start HRT?
The best time to start HRT is usually soon after menopause symptoms begin, or within around ten years of menopause. Starting early can help you get the greatest benefit – from easing symptoms to protecting long-term health. However, it’s never too late to explore your options. Even if menopause began some time ago, HRT can still make a difference to your comfort, energy, and quality of life.
The right approach depends on your individual health, symptoms, and goals – and our specialists are here to help you find what works best for you.
What are the risks of HRT?
Like any hormone-based treatment, HRT carries some risks.
For most healthy women under 60, benefits tend to outweigh risks of beginning treatment. A small increase in breast-cancer risk is linked to combined (oestrogen + progestogen) HRT; whilst the risk appears lower for oestrogen-only preparations. Some forms of HRT may slightly raise the risk of blood clots, particularly certain oral tablets.
When talking with one of our menopause specialists, it's important to have a discussion about your personal health history and what your treatment preferences are (if you have any).
Struggling with symptoms?
Menopause can bring a range of physical, emotional, and cognitive symptoms that significantly impact your daily life and overall wellbeing. Our menopause symptom checker can give you fully personalised insights into your health in minutes.
What our patients say
Lynne is very knowledgeable and thorough. She answered all our questions with patience and put our mind at ease. Thank you very much Lynne
— Patient of Lynne RobinsonJacqueline was very empathetic and knowledgeable. I felt she listened to my concerns and was very helpful.
— Patient of Jacqueline RadleyDr Radley, was very welcoming, professional & caring. She listened to me explaining my symptoms & understood. Reassured me that what I was experiencing, there was a reason for it. Would highly recommend Dr Radley to my family & friends.
— Patient of Jacqueline RadleyDr Radley was very patient and attentive whilst I was talking and took in all my information, queries and requests during the appointment. She had all the answers to my questions, provided a summary of our conversation and was very pleasant and helpful.
— Patient of Jacqueline RadleyExcellent knowledge and explained clearly about treatment for the Menopause was best for me Put me at complete ease and felt very comfortable talking to her
— Patient of Jacqueline RadleyHelped my wife and I understand with fertility
— Patient of Lynne RobinsonIt was SO much easier to do the appointment by Teams than battle the traffic and arrive stressed, and we achieved the same result! Always a pleasure to have the calm, reassuring presence of Dr Radley in my corner
— Patient of Jacqueline RadleyDr Radley was very easy to talk to and very helpful
— Patient of Jacqueline RadleyIt felt really reassuring to speak with Dr Radley. She was both informative and professional and I valued being listened too.
— Patient of Jacqueline RadleyLynne is very knowledgeable and thorough. She answered all our questions with patience and put our mind at ease. Thank you very much Lynne
— Patient of Lynne RobinsonJacqueline was very empathetic and knowledgeable. I felt she listened to my concerns and was very helpful.
— Patient of Jacqueline RadleyDr Radley, was very welcoming, professional & caring. She listened to me explaining my symptoms & understood. Reassured me that what I was experiencing, there was a reason for it. Would highly recommend Dr Radley to my family & friends.
— Patient of Jacqueline RadleyDr Radley was very patient and attentive whilst I was talking and took in all my information, queries and requests during the appointment. She had all the answers to my questions, provided a summary of our conversation and was very pleasant and helpful.
— Patient of Jacqueline RadleyExcellent knowledge and explained clearly about treatment for the Menopause was best for me Put me at complete ease and felt very comfortable talking to her
— Patient of Jacqueline RadleyHelped my wife and I understand with fertility
— Patient of Lynne RobinsonIt was SO much easier to do the appointment by Teams than battle the traffic and arrive stressed, and we achieved the same result! Always a pleasure to have the calm, reassuring presence of Dr Radley in my corner
— Patient of Jacqueline RadleyDr Radley was very easy to talk to and very helpful
— Patient of Jacqueline RadleyIt felt really reassuring to speak with Dr Radley. She was both informative and professional and I valued being listened too.
— Patient of Jacqueline Radley