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 was very understanding and knowledgable. , she also commended me on my own research and understanding . She explained everything I needed to know and was very understanding of me being pushed for time , she tried not to keep me too long , many thanks to her .
— Patient of Jacqueline RadleyDr Radley was very professional and reassuring
— Patient of Jacqueline RadleyIt was my first time speaking to Dr Radley. And I feel it’s the first time I’ve been properly listened to. And she really understood and came up with options to help me through the menopause. Very thorough with the questions regarding past history and family. And very reassuring for going forward
— Patient of Jacqueline RadleyIt was so nice to be listened to and heard. Dr Radley was understanding and thoughtful in her manner and communication. Gave great information and insight in to my symptoms and showed great empathy. Thank you
— Patient of Jacqueline RadleyGreatly appreciated the consultant action. Dr Radley seem to connect with her patient sensitively and felt she gave patient focused care and action plan, which is very valuable. I have appreciated her time and understanding of my circumstances. Thank you 🙏
— Patient of Jacqueline RadleyDr Radley was very patient and detailed in her responses. She took the time to listen to me and explored my symptoms with a sympathetic ear. I highly recommend her for a peri menopause / HRT consultation
— Patient of Jacqueline RadleyDr Radley explained everything I needed to know in detail. I am really pleased how the call went.
— Patient of Jacqueline RadleyAppointment ran smoothly. Dr Radley gained a good understanding of my issues; she is very informative and answered my questions thoughtfully.
— Patient of Jacqueline RadleyI have battled my menopause symptoms for over 2 years and was desperate to be heard and not fobbed off . Dr Radley was amazing . She listened to me and suggested various options . I recently went for a check up 3 months after starting a change in my HRT and feel a new woman. Thank you so much- would definitely recommend to anyone who is struggling with the menopause .
— Patient of Jacqueline RadleyDr was very understanding and knowledgable. , she also commended me on my own research and understanding . She explained everything I needed to know and was very understanding of me being pushed for time , she tried not to keep me too long , many thanks to her .
— Patient of Jacqueline RadleyDr Radley was very professional and reassuring
— Patient of Jacqueline RadleyIt was my first time speaking to Dr Radley. And I feel it’s the first time I’ve been properly listened to. And she really understood and came up with options to help me through the menopause. Very thorough with the questions regarding past history and family. And very reassuring for going forward
— Patient of Jacqueline RadleyIt was so nice to be listened to and heard. Dr Radley was understanding and thoughtful in her manner and communication. Gave great information and insight in to my symptoms and showed great empathy. Thank you
— Patient of Jacqueline RadleyGreatly appreciated the consultant action. Dr Radley seem to connect with her patient sensitively and felt she gave patient focused care and action plan, which is very valuable. I have appreciated her time and understanding of my circumstances. Thank you 🙏
— Patient of Jacqueline RadleyDr Radley was very patient and detailed in her responses. She took the time to listen to me and explored my symptoms with a sympathetic ear. I highly recommend her for a peri menopause / HRT consultation
— Patient of Jacqueline RadleyDr Radley explained everything I needed to know in detail. I am really pleased how the call went.
— Patient of Jacqueline RadleyAppointment ran smoothly. Dr Radley gained a good understanding of my issues; she is very informative and answered my questions thoughtfully.
— Patient of Jacqueline RadleyI have battled my menopause symptoms for over 2 years and was desperate to be heard and not fobbed off . Dr Radley was amazing . She listened to me and suggested various options . I recently went for a check up 3 months after starting a change in my HRT and feel a new woman. Thank you so much- would definitely recommend to anyone who is struggling with the menopause .
— Patient of Jacqueline Radley