Hormone Replacement Therapy

Key takeaways

• Systemic HRT treats whole-body symptoms, while local vaginal oestrogen targets vaginal and urinary symptoms with different exposure.
• A person with a uterus usually needs progestogen protection alongside systemic oestrogen to reduce endometrial risk.
• Unexplained bleeding, clotting history and hormone-sensitive cancer need individual assessment before treatment.

An HRT listing does not identify a suitable regimen; symptom pattern, uterus status, medical history and personal priorities guide prescribing.

Which symptoms can HRT help?

Systemic treatment is effective for vasomotor symptoms and helps prevent bone loss while it is used. Local treatment may be enough for vaginal dryness or discomfort. Premature ovarian insufficiency and surgical menopause involve different long-term considerations from menopause at the usual age.

What affects medicine choice?

Oestrogen may be oral or transdermal; progesterone or another progestogen may be added. Clotting, migraine, liver disease, cardiovascular risk and breast or endometrial history affect route and suitability. Regular review in women’s health care considers symptom control and changing risk.

When to seek urgent care

Seek emergency help for chest pain, sudden breathlessness, coughing blood, one-sided leg swelling, stroke symptoms or a severe allergic reaction. New unexplained vaginal bleeding requires prompt assessment.