Hormone replacement therapy - pills, patches or gels?

HRT is a medication that you will be taking for a minimum of a few months and possibly for several years. You should therefore talk through all your worries with the person prescribing the medication and make sure that you understand the benefits, risks and potential long-term problems associated with your HRT. Don't be afraid to go back to your doctor if you develop side effects or unusual bleeding.

HRT considerations
Most women will need to take both an oestrogen and a progestogen. If you have had a hysterectomy you will only need to take oestrogen but if you still have your uterus you need to protect yourself from the increased risk of endometrial cancer that taking oestrogen alone will confer.

If you are in the perimenopause or within a year of your last period you will be prescribed progestogens cyclically, in other words you will take them for 12-14 days each four weeks and when you stop taking them you will bleed for a few days. In this way you will appear to have a regular period. You may not then know when your natural menopause occurs.

Types of treatment
HRT is available in tablet and skin patch forms, with different blood levels of oestrogen being reached depending on your personal metabolism. The highest levels are achieved by having an implant, which is a small pellet of hormone inserted under the skin using a local anaesthetic.