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
Felt 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 RadleyExcellent consultation, clear explanation and options discussed with pros and cons of options, learnt a lot. I would highly recommend Dr Radley for her attitude, knowledge and kindness. She truly has the best interest of her patients at heart.
— Patient of Jacqueline RadleyFollowing my recent hysterectomy, I was catapulted into a surgical menopause. I had previously seen Dr Radley when I was perimenopausal and she had helped me with symptoms I had been struggling with. After my hysterectomy and the removal of my ovaries I had been in a terrible state suffering with extreme hot sweats that were 24/7, depression, anxiety, insomnia and itching skin. I honestly thought I was cracking up and became isolated. I went back to see Dr Radley who was amazing. She listened to me and reassured me that I wasn’t going mad. After discussing my symptoms, she explained everything to me and my husband and for the first time in the two weeks since my operation, I felt calm. I’m now having blood tests to check my hormone levels and then Dr Radley will decide on an increase to my HRT. I would honestly recommend Dr Radley to any woman who is on the menopause journey because there is no reason to suffer in silence when there is help available . Thank you so much Dr Radley.
— Patient of Jacqueline RadleyDr Radley was kind, caring and showed compassion. She explained everything in detail and made me feel relaxed throughout my appointment
— Patient of Jacqueline RadleyThe doctor was very helpful and asked lots of questions to understand my concerns and issues. I was very grateful.
— Patient of Jacqueline RadleyDoctor was very reassuring and explained everything extremely well. I’m happy with the outcome of my appointment. Thank you doctor Radley.
— 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 RadleyExcellent consultation, clear explanation and options discussed with pros and cons of options, learnt a lot. I would highly recommend Dr Radley for her attitude, knowledge and kindness. She truly has the best interest of her patients at heart.
— Patient of Jacqueline RadleyFollowing my recent hysterectomy, I was catapulted into a surgical menopause. I had previously seen Dr Radley when I was perimenopausal and she had helped me with symptoms I had been struggling with. After my hysterectomy and the removal of my ovaries I had been in a terrible state suffering with extreme hot sweats that were 24/7, depression, anxiety, insomnia and itching skin. I honestly thought I was cracking up and became isolated. I went back to see Dr Radley who was amazing. She listened to me and reassured me that I wasn’t going mad. After discussing my symptoms, she explained everything to me and my husband and for the first time in the two weeks since my operation, I felt calm. I’m now having blood tests to check my hormone levels and then Dr Radley will decide on an increase to my HRT. I would honestly recommend Dr Radley to any woman who is on the menopause journey because there is no reason to suffer in silence when there is help available . Thank you so much Dr Radley.
— Patient of Jacqueline RadleyDr Radley was kind, caring and showed compassion. She explained everything in detail and made me feel relaxed throughout my appointment
— Patient of Jacqueline RadleyThe doctor was very helpful and asked lots of questions to understand my concerns and issues. I was very grateful.
— Patient of Jacqueline RadleyDoctor was very reassuring and explained everything extremely well. I’m happy with the outcome of my appointment. Thank you doctor Radley.
— Patient of Jacqueline Radley