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 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 RadleyI had a telephone consultation with Dr Radley She’s absolutely fantastic so understanding and caring and doesn’t shrug you off. I feel I’m listened to not just a number and my symptoms are not just in my head! 😢 There’s should be more doctors like her!!! Credit to Dr Tadley
— Patient of Jacqueline RadleyI had an excellent consultation with Dr Radley. She was exceptionally thorough, knowledgeable, and professional throughout. What really stood out was that every treatment recommendation and plan was clearly explained and supported by current research and evidence, which gave me great confidence in the decisions we made together. She took the time to explore all of my symptoms and concerns in detail, listening carefully without ever making me feel rushed. Her approach was warm, empathetic, and compassionate, and she explained her clinical reasoning in a way that was easy to understand while still being comprehensive. I left the appointment feeling heard, reassured, and genuinely optimistic. I really valued both her expertise and the generous amount of time she dedicated to my consultation. I would highly recommend her to anyone seeking specialist menopause care
— Patient of Jacqueline RadleySo professional, caring and understanding. Dr Radley was so informative and helpful honestly was so happy with the consultation and the outcome, thank you so much, you made be feel so heard xx
— Patient of Jacqueline RadleyI felt safe and listened to! However it has been 9 days and I have had no letter response which is disappointing
— Patient of Jacqueline RadleyFelt listened to and understood. Good clear explanations and justification with additional professional advice based on research. Really pleased with the plan and how to access support if needed in the meantime. Very pleased with the consultation and felt as if my concerns mattered and made sense. She spent as much time as needed to get us to a plan and cover all the aspects raised. Superb service. Thank you..
— Patient of Jacqueline RadleyDr Radley always answers all my questions fully during my appointment, passing on helpful knowledge, really useful advice and leaves me feeling totally reassured.
— Patient of Jacqueline RadleyWas very nervous for our appointment but Lynne made us feel very welcome and was thorough.
— Patient of Lynne RobinsonVery informative & supportive.
— 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 RadleyI had a telephone consultation with Dr Radley She’s absolutely fantastic so understanding and caring and doesn’t shrug you off. I feel I’m listened to not just a number and my symptoms are not just in my head! 😢 There’s should be more doctors like her!!! Credit to Dr Tadley
— Patient of Jacqueline RadleyI had an excellent consultation with Dr Radley. She was exceptionally thorough, knowledgeable, and professional throughout. What really stood out was that every treatment recommendation and plan was clearly explained and supported by current research and evidence, which gave me great confidence in the decisions we made together. She took the time to explore all of my symptoms and concerns in detail, listening carefully without ever making me feel rushed. Her approach was warm, empathetic, and compassionate, and she explained her clinical reasoning in a way that was easy to understand while still being comprehensive. I left the appointment feeling heard, reassured, and genuinely optimistic. I really valued both her expertise and the generous amount of time she dedicated to my consultation. I would highly recommend her to anyone seeking specialist menopause care
— Patient of Jacqueline RadleySo professional, caring and understanding. Dr Radley was so informative and helpful honestly was so happy with the consultation and the outcome, thank you so much, you made be feel so heard xx
— Patient of Jacqueline RadleyI felt safe and listened to! However it has been 9 days and I have had no letter response which is disappointing
— Patient of Jacqueline RadleyFelt listened to and understood. Good clear explanations and justification with additional professional advice based on research. Really pleased with the plan and how to access support if needed in the meantime. Very pleased with the consultation and felt as if my concerns mattered and made sense. She spent as much time as needed to get us to a plan and cover all the aspects raised. Superb service. Thank you..
— Patient of Jacqueline RadleyDr Radley always answers all my questions fully during my appointment, passing on helpful knowledge, really useful advice and leaves me feeling totally reassured.
— Patient of Jacqueline RadleyWas very nervous for our appointment but Lynne made us feel very welcome and was thorough.
— Patient of Lynne RobinsonVery informative & supportive.
— Patient of Jacqueline Radley