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
Dr Radley was wonderful I can’t thank her enough for all her help. Everything was explained to me and the whole conversation was lovely.
— Patient of Jacqueline RadleyDr Radley listen to Queestions and was so understanding and explained everything I needed to know as well as my concerns . She explain in detail what was going to happen and helped me so much and put my mind at ease . I appreciate everything she has done and doing for me .
— Patient of Jacqueline RadleyI wasn't expecting the dr to be very understanding, from past experience they tend to be dismissive and don't care how the patient feels. Dr Radley was very understanding and attentive. Took her time and didn't make me feel rushed. Would be very happy to speak to her again.
— Patient of Jacqueline RadleyI am so pleased with my telephone appointment. I feel like I’ve been listened to at last and that doctor Bradley listened to me and showed compassion and understanding about my menopause symptoms. And can’t believe that at last I’m getting some help so I thankyou so much doctor Bradley
— Patient of Jacqueline RadleyThe Doctor gave me a very good and clear explanation about my concern and she was really helpful
— Patient of Jacqueline RadleyListened to everything and explained things. Very knowledgeable and understanding and came up with things to change and do.
— Patient of Jacqueline RadleyEverything was clearly explained and options discussed. Took the time to listen and share the information I asked for.
— Patient of Jacqueline RadleyDr. Radley is an exceptional doctor with a remarkable ability to listen. She creates a reassuring and supportive environment where you no longer feel isolated or alienated by your experiences. She guides, supports, and empowers you to find the solution that is right for you, always taking a patient-centred approach. Dr. Radley clearly explains the rationale behind her recommendations, ensuring you feel informed and involved in every step of your care. She collaborates effectively with multidisciplinary teams to achieve the best possible outcomes, seeking holistic, life-changing solutions that address your overall health and wellbeing. Dr. Radley's compassion, expertise, and dedication make her a truly exceptional doctor, and I cannot recommend her highly enough. > Dr. Radley is an exceptional doctor with a remarkable ability to listen. She creates a reassuring and supportive environment where you no longer feel isolated or alienated by your experiences. She guides, supports, and empowers you to find the solution that is right for you, always taking a patient-centred approach. Dr. Radley clearly explains the rationale behind her recommendations, ensuring you feel informed and involved in every step of your care. She collaborates effectively with multidisciplinary teams to achieve the best possible outcomes, seeking holistic, life-changing solutions that address your overall health and wellbeing. Dr. Radley's compassion, expertise, and dedication make her a truly exceptional doctor, and I cannot recommend her highly enough.
— Patient of Jacqueline RadleyDr Radley listened carefully to all my concerns. I did not feel dismissed at all. She took the time to explain the different treatment options available to me. She helped tailor my medication to suit me as I suffer from a couple of other conditions. I had lots of questions to ask and she patiently answered all of them. I wish all doctors took the time to listen and explain things to patients like Dr Radley. I’m so glad I had her as my doctor. Thank you.
— Patient of Jacqueline RadleyDr Radley was wonderful I can’t thank her enough for all her help. Everything was explained to me and the whole conversation was lovely.
— Patient of Jacqueline RadleyDr Radley listen to Queestions and was so understanding and explained everything I needed to know as well as my concerns . She explain in detail what was going to happen and helped me so much and put my mind at ease . I appreciate everything she has done and doing for me .
— Patient of Jacqueline RadleyI wasn't expecting the dr to be very understanding, from past experience they tend to be dismissive and don't care how the patient feels. Dr Radley was very understanding and attentive. Took her time and didn't make me feel rushed. Would be very happy to speak to her again.
— Patient of Jacqueline RadleyI am so pleased with my telephone appointment. I feel like I’ve been listened to at last and that doctor Bradley listened to me and showed compassion and understanding about my menopause symptoms. And can’t believe that at last I’m getting some help so I thankyou so much doctor Bradley
— Patient of Jacqueline RadleyThe Doctor gave me a very good and clear explanation about my concern and she was really helpful
— Patient of Jacqueline RadleyListened to everything and explained things. Very knowledgeable and understanding and came up with things to change and do.
— Patient of Jacqueline RadleyEverything was clearly explained and options discussed. Took the time to listen and share the information I asked for.
— Patient of Jacqueline RadleyDr. Radley is an exceptional doctor with a remarkable ability to listen. She creates a reassuring and supportive environment where you no longer feel isolated or alienated by your experiences. She guides, supports, and empowers you to find the solution that is right for you, always taking a patient-centred approach. Dr. Radley clearly explains the rationale behind her recommendations, ensuring you feel informed and involved in every step of your care. She collaborates effectively with multidisciplinary teams to achieve the best possible outcomes, seeking holistic, life-changing solutions that address your overall health and wellbeing. Dr. Radley's compassion, expertise, and dedication make her a truly exceptional doctor, and I cannot recommend her highly enough. > Dr. Radley is an exceptional doctor with a remarkable ability to listen. She creates a reassuring and supportive environment where you no longer feel isolated or alienated by your experiences. She guides, supports, and empowers you to find the solution that is right for you, always taking a patient-centred approach. Dr. Radley clearly explains the rationale behind her recommendations, ensuring you feel informed and involved in every step of your care. She collaborates effectively with multidisciplinary teams to achieve the best possible outcomes, seeking holistic, life-changing solutions that address your overall health and wellbeing. Dr. Radley's compassion, expertise, and dedication make her a truly exceptional doctor, and I cannot recommend her highly enough.
— Patient of Jacqueline RadleyDr Radley listened carefully to all my concerns. I did not feel dismissed at all. She took the time to explain the different treatment options available to me. She helped tailor my medication to suit me as I suffer from a couple of other conditions. I had lots of questions to ask and she patiently answered all of them. I wish all doctors took the time to listen and explain things to patients like Dr Radley. I’m so glad I had her as my doctor. Thank you.
— Patient of Jacqueline Radley