What Is Menopause?

Menopause is a natural part of life, usually happening between ages 45 and 55, when your periods stop for good. This change happens because your body slowly makes less of certain hormones — mainly oestrogen and progesterone. Before menopause, many people go through a phase called perimenopause, which can last several years and bring a mix of symptoms.

Common symptoms include:

• Sudden feelings of heat (hot flushes) or sweating at night
• Trouble sleeping
• Feeling low, anxious, or easily irritated
• Difficulty focusing or remembering things
• Vaginal dryness or discomfort
• Less interest in sex
• Achy joints or muscles
• More frequent urine infections

These symptoms can vary from person to person. Some find them mild, while others feel they affect daily life.

How Can HRT Help?

Hormone Replacement Therapy (HRT) is a treatment that gently replaces the oestrogen your body is no longer making. If you still have a womb, you’ll also need progesterone to protect it. HRT can ease many menopause symptoms and help protect your bones as you age.

HRT may help you:

• Feel more comfortable by reducing hot flushes and night sweats
• Sleep better and feel more emotionally balanced
• Stay active and strong by protecting your bones
• Feel more comfortable during sex and reduce dryness

There’s no set age to start or stop HRT. What matters is how you feel and what suits your health and lifestyle.

What Are My Options?

HRT comes in different forms. Your doctor or nurse will help you choose what’s best for you.

Some people use more than one type depending on their symptoms.

What Are the Benefits and Risks?

Benefits:

• Eases many menopause symptoms
• Helps you sleep and feel more like yourself
• Keeps your bones strong and lowers the chance of fractures
• May support heart and brain health if started around menopause

Risks:

• A small increase in breast cancer risk with long-term use of combined HRT (oestrogen and progesterone)
• Slightly higher chance of blood clots with tablets (not with skin patches or gels)
• If you still have a womb, you’ll need progesterone to protect it
• A very small increase in the chance of ovarian cancer

Your doctor will talk through these risks and help you decide what’s right for you.

What Happens Before Starting HRT?

We’ll guide you through a few simple steps:

1. A chat with your GP or nurse about your symptoms and health history
2. A check-up to measure your blood pressure and weight, and update any routine screenings
3. A follow-up after three months to see how you’re doing
4. A yearly review to make sure HRT is still working well for you

Are There Any Side Effects?

Some people notice mild side effects when starting HRT, but these often settle within a few months.

You might notice:

• Tender breasts or feeling bloated
• Feeling sick (taking tablets with food at night may help)
• Skin irritation from patches
• Light bleeding (especially in the first few months — book appointment to discuss this with your GP)

If anything worries you, we’re here to help.

Other Things to Keep in Mind

• HRT is not a form of birth control. You may still need contraception depending on your age and last period.
• If you’ve had migraines or blood clot issues, skin-based HRT is usually safer.
• If your periods stopped early (before age 40), HRT is especially important to protect your bones and heart until around age 51.

What If I Don’t Want HRT?

There are other ways to manage symptoms if HRT isn’t right for you:

• Talking therapies like CBT can help with mood and sleep
• Staying active, eating well, and cutting back on alcohol or smoking
• Using vaginal moisturisers or lubricants for dryness
• Joining support groups like Menopause Matters or The Daisy Network

Helpful Resources

You can find more information and support from:

• NHS: Menopause & HRT
  Clear guidance on symptoms, treatment options, and when to seek help.
• British Menopause Society (BMS)
  Professional and patient resources, including factsheets and clinical updates.
• Menopause Matters
  Independent site with forums, treatment comparisons, and symptom trackers.
• Menopausesupport.co.uk

For patient information leaflet