Menopause hormonal therapy

Previously called hormone replacement therapy or HRT

What is menopause hormonal therapy?

Menopause hormonal therapy (previously called hormone replacement therapy or HRT) is the use of the hormone oestrogen to replace the oestrogen that your ovaries no longer make after menopause.

  • In women who still have their uterus, oestrogen alone can overstimulate the cells lining the uterus causing an increased risk of endometrial cancer (cancer of the uterus). To counter this risk, women who have a uterus need to take progestogen together with oestrogen.
  • In women who have had a hysterectomy (uterus has been removed surgically), there is no need to combine progestogen with oestrogen, and oestrogen alone is fine. 
  • Menopause hormonal therapy is used to ease the symptoms associated with menopause such as:
    • hot flushes
    • night sweats
    • sleep problems
    • headaches
    • vaginal dryness. 

Examples of menopause hormonal therapy

Menopause hormonal therapy is available as oestrogen alone, or oestrogen in combination with progestogen. It is also available in different formulations such as tablets, and skin patches. The following are examples of menopause hormonal therapy products that are available in New Zealand:  

Oestrogen only (tablets)

  • Estrofem®
  • Progynova® 
  • Ovestin®
  • Premarin®

Oestrogen only (skin patch)

  • Estradot®
  • Climara®

Oestrogen plus progestogen (tablets)

  • Trisequens® 
  • Kliogest®
  • Kliovance® 
  • Femoston 2/10®
  • Premia®

Oestrogen plus progestogen (skin patch)

  • Estalis Continuous® 

What are the benefits of taking menopause hormonal therapy

  • Without treatment, menopausal symptoms such as hot flushes, night sweats, sleep problems and headaches tend to last for 2 to 5 years in most women. 
  • Menopause hormonal therapy has been found to:
    • reduce the number and severity of hot flashes and night sweats
    • improve symptoms of vaginal dryness and soreness
    • help to reduce recurrent urine infections.
  • Menopause hormonal therapy is also found to lower the risk of osteoporosis since oestrogen slows bone thinning and helps increase bone thickness.

What are the risks of menopause hormonal therapy

  • Women who take menopause hormonal therapy have slightly higher rates of:
    • blood clots
    • heart attack
    • stroke
    • gallstones
    • urinary incontinence
    • breast cancer
    • ovarian cancer
    • dementia. 1
When assessing the risks associated with menopause hormonal therapy, it is important to remember that not all women will have the same risk of these effects. For example:
  • Risks vary based on when you start menopause hormonal therapy, and how long you take it for. Short-term use in early menopause has less risks than when it is started later in menopause.
  • The risks of developing blood clots while taking menopause hormonal therapy is much higher in women who are obese, have severe varicose veins, or who have a close family member who has had  deep vein thrombosis or pulmonary embolism.

Learn more

The following links provide further information on menopause hormonal therapy. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Medsafe Consumer Information Sheets:

Trisequens
Kliogest
Kliovance 
Progynova
Estradot
Climara
Premia
Premarin

Menopause and HRT  Patient Info, UK
Facts about menopausal hormone therapy United States, NIH

References

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 26 Oct 2015