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
The 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 RadleyThe kind doctor really listened to my concerns , she was clear in explaining why I’m having these awful symptoms. She advised on a medication that would best suit my needs . It felt the first time I’ve been really listened too . She also advised on a diet that might help . I didn’t feel so alone after the call , or that I was sometimes going mad with the awful forgetfulness. Thank you .
— Patient of Jacqueline RadleyMy overall experience with lynne Robinson has been really reassuring , she has really listened to my medical history and taken the time to put a plan together … i feel a lot better knowing where I am and how to handle my menstrual cycles . A very kind and approachable consultant she has a lot of knowledge and empathy to help me … we have a clear plan and will meet again in six months for review thanks so much Also to Louise her secretary who has been very efficient and kind . She has bin on the other end of the phone if I needed things checking and only and e mail or phone call away . Very nice to have a secretary that not only cares but very approachable. Thanks Louise . I would definitely recommend for gyne issues to use this consultatant … 😊 you are passionate about what you do .
— Patient of Lynne RobinsonMiss Robinson was absolutely wonderful. She is clearly very knowledgeable and experienced in the field of menopause and I learnt a lot during our conversation. I was extremely impressed that she clearly must have cared about my situation because, after my visit, she took the time to discuss my case with a consultant in a different field and sought advice. She then relayed that advice to me promptly via email and also contacted my local hospital to relay the advice and request that I have further investigations/examinations. I felt very reassured by her advices and calm demeanor.
— Patient of Lynne RobinsonMiss Robinson is extremely attentive and considerate of your personal circumstances. She makes you feel heard and comfortable.
— Patient of Lynne RobinsonConstructive advise and gained reassurances with a plan on my HRT programme
— Patient of Jacqueline RadleyI felt listened to and felt reassured that Dr Radley had up to date knowledge and understanding of managing menopause symptoms. I am relieved that I got to speak to someone who listened and clearly detailed the risks benefits and forward plan. Thank you.
— Patient of Jacqueline RadleyDr Radley was very kind and sympathetic- as always.. She is extremely thorough and checked out my blood results and discussed how I was feeling re the HRT. She also promised to follow up outstanding queries I had with my GP regarding test results I just hadn’t been informed about. True to her word I received confirmation that I had been referred to cardiology and also confirmation of an appointment with them.. Without her, I would still be in the dark about what my results were as the GP had been totally unresponsive.
— 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 RadleyThe kind doctor really listened to my concerns , she was clear in explaining why I’m having these awful symptoms. She advised on a medication that would best suit my needs . It felt the first time I’ve been really listened too . She also advised on a diet that might help . I didn’t feel so alone after the call , or that I was sometimes going mad with the awful forgetfulness. Thank you .
— Patient of Jacqueline RadleyMy overall experience with lynne Robinson has been really reassuring , she has really listened to my medical history and taken the time to put a plan together … i feel a lot better knowing where I am and how to handle my menstrual cycles . A very kind and approachable consultant she has a lot of knowledge and empathy to help me … we have a clear plan and will meet again in six months for review thanks so much Also to Louise her secretary who has been very efficient and kind . She has bin on the other end of the phone if I needed things checking and only and e mail or phone call away . Very nice to have a secretary that not only cares but very approachable. Thanks Louise . I would definitely recommend for gyne issues to use this consultatant … 😊 you are passionate about what you do .
— Patient of Lynne RobinsonMiss Robinson was absolutely wonderful. She is clearly very knowledgeable and experienced in the field of menopause and I learnt a lot during our conversation. I was extremely impressed that she clearly must have cared about my situation because, after my visit, she took the time to discuss my case with a consultant in a different field and sought advice. She then relayed that advice to me promptly via email and also contacted my local hospital to relay the advice and request that I have further investigations/examinations. I felt very reassured by her advices and calm demeanor.
— Patient of Lynne RobinsonMiss Robinson is extremely attentive and considerate of your personal circumstances. She makes you feel heard and comfortable.
— Patient of Lynne RobinsonConstructive advise and gained reassurances with a plan on my HRT programme
— Patient of Jacqueline RadleyI felt listened to and felt reassured that Dr Radley had up to date knowledge and understanding of managing menopause symptoms. I am relieved that I got to speak to someone who listened and clearly detailed the risks benefits and forward plan. Thank you.
— Patient of Jacqueline RadleyDr Radley was very kind and sympathetic- as always.. She is extremely thorough and checked out my blood results and discussed how I was feeling re the HRT. She also promised to follow up outstanding queries I had with my GP regarding test results I just hadn’t been informed about. True to her word I received confirmation that I had been referred to cardiology and also confirmation of an appointment with them.. Without her, I would still be in the dark about what my results were as the GP had been totally unresponsive.
— Patient of Jacqueline Radley