Hormone replacement therapy - pills, patches or gels?

Another option is continuous combined HRT. These tablets contain a constant amount of oestrogen and progestogen and mean that you do not have a regular bleed. They should only be prescribed when you are at least 12 months after your last natural period or you may experience spotting and irregular bleeding. The problem is that you may not know when this occurs when you have been taking HRT for some time. For this reason doctors tend to wait until you are 54 or older to give this type of HRT.

Who can take HRT?
Some women should not take oestrogens, though not as many as was once thought. Here are a few reasons.

• Unexplained vaginal bleeding until you know there is no serious cause
  
• Active breast cancer (women who are in remission and have no active disease may be able to take it under close medical supervision)
  
• Severe or active liver diseaseM

• Endometriosis - may be reactivated by HRT
  
• Fibroids - may enlarge and cause troublesome bleeding
  
• Women with a past problem with blood clots in veins (thromboembolism) need to be tested to make sure they are not at risk of developing further clots, which are slightly more common on HRT