Perimenopausia y menopausia

HRT and other treatments

Revisado: 4 de octubre de 2026

Solo en inglés por ahora

Hormone replacement therapy (HRT) relieves most menopause symptoms and helps protect your bones. Here is a balanced look at its benefits and risks, and at options without hormones.

What HRT is

Hormone replacement therapy (HRT) replaces hormones that your body makes less of around menopause. Oestrogen is the main hormone, and it can be taken as tablets or used as patches, a spray or a gel. If you still have a womb, you usually take oestrogen with progestogen (combined HRT). The progestogen can be taken as tablets, in a combined patch or through a hormonal coil (IUS). If your womb has been removed, oestrogen on its own is usually enough.

How HRT can help

HRT relieves most symptoms of perimenopause and menopause. This includes hot flushes, night sweats, sleep problems, vaginal dryness, and anxiety and low mood caused by menopause. It also helps prevent osteoporosis, the condition that makes bones weak, and it can help your muscles stay strong. Some people are also offered testosterone gel or cream, which can help with low sex drive. For most people, the benefits of HRT outweigh the risks.

Risks to know about

HRT can slightly increase the risk of breast cancer. With combined HRT, there are around 5 extra cases of breast cancer for every 1,000 women who take it for 5 years. Oestrogen-only HRT causes little or no increase. The risk goes up the longer you take HRT and the older you are, and it falls again after you stop. HRT tablets can raise the risk of blood clots and slightly raise the risk of stroke, but both risks are still very low. HRT patches, sprays and gels do not raise either risk. HRT has little or no effect on the risk of heart disease. For most people, serious side effects from HRT are rare.

Other options

If you cannot take HRT or prefer not to, there are other options. Cognitive behavioural therapy (CBT), a type of talking therapy, can help with menopause symptoms. Some medicines also used for depression, epilepsy or high blood pressure may help with hot flushes. Clonidine is one example. For vaginal dryness, moisturisers and water-based lubricants can help, and oestrogen used as a vaginal cream or pessary is another option. There is very little evidence on how well herbal remedies work or how safe they are.

Making your decision

Whether to take HRT is a personal choice. It depends on your symptoms, your health, and how you weigh up the benefits and risks. HRT may not suit you if you have had breast, ovarian or womb cancer or a blood clot, or if you have untreated high blood pressure or liver disease. HRT does not prevent pregnancy, so you may still need contraception for a while. Noting your symptoms in Ciclo for a few weeks before an appointment can help you describe what affects you most.

When to get help

Irregular bleeding or spotting is common in the first months of HRT and usually settles within 6 months. See a doctor if it lasts longer than 6 months, gets heavier, or starts after your bleeding had stopped. Get help urgently if one leg becomes painful or swollen, often in the calf or thigh, or the skin there looks red or darker. Call your local emergency number if you also feel short of breath or have chest pain.

This is general information. Decisions about HRT are personal and best made with a doctor or nurse who knows your health history.