Menopause and HRT: A Practical Overview

What is the menopause?

Menopause is the natural point when a woman's periods stop permanently, usually confirmed after twelve consecutive months without a period. The years of changing hormone levels leading up to it are called the perimenopause. Most women reach menopause in their late forties or early fifties, although it can happen earlier, sometimes after surgery or certain medical treatments.

The central change is a fall in oestrogen and progesterone produced by the ovaries. Because these hormones influence far more than the reproductive system, their decline can affect mood, sleep, temperature regulation, bone strength and the tissues of the vagina and bladder.

Common symptoms

Symptoms vary enormously from one woman to the next. Some notice very little, while others find daily life disrupted. Frequently reported experiences include:

• Hot flushes and night sweats
• Difficulty sleeping and fatigue
• Low mood, anxiety or irritability
• Brain fog and trouble concentrating
• Vaginal dryness and discomfort during sex
• Reduced libido
• Joint aches and changes in skin or hair

Symptoms can last for several years and may come and go. Keeping a simple diary of what you notice can help you and your clinician make sense of the pattern.

What is HRT?

Hormone replacement therapy (HRT) replaces some of the hormones the body no longer makes in the same quantities. It typically involves oestrogen, given as tablets, skin patches, gels or sprays. Women who still have a womb are usually also given a progestogen to protect the lining of the womb. A separate vaginal oestrogen can be used for local symptoms such as dryness.

HRT is not a single product but a family of treatments, and the right combination depends on your symptoms, your medical history and your personal preferences.

How HRT may help

For many women, HRT is the most effective option for relieving troublesome menopausal symptoms, particularly hot flushes, night sweats and vaginal discomfort. It can also help protect bone density, which naturally declines after menopause. Some women report improvements in sleep and mood once their symptoms settle.

HRT is not a treatment that suits everyone, and it is not designed to reverse ageing or guarantee any outcome. The aim is to ease symptoms enough to improve quality of life.

Weighing the decision

Deciding whether to start HRT is a genuinely individual choice. There are recognised benefits and recognised risks, and these are weighed differently depending on your age, the type of HRT, how it is taken and your own health background. For a closer look at this balance, see our companion guide on HRT benefits and risks.

Good questions to discuss with your doctor include:

• Which symptoms are affecting me most?
• Do I have any conditions that make certain options less suitable?
• What type and route of HRT might suit me?
• How will we review whether it is working?

Non-hormonal approaches

HRT is not the only route. Lifestyle measures such as regular exercise, limiting alcohol and caffeine, managing stress and keeping bedrooms cool can ease some symptoms. Certain non-hormonal medicines and talking therapies may also help, particularly where HRT is not appropriate. A pharmacist can talk you through options available to you.

Looking after the rest of your health

Menopause is a useful moment to review general wellbeing: bone health, heart health, blood pressure and emotional wellbeing all deserve attention at this stage of life. You can browse our wider shop all range for everyday health products, and our FAQ answers common questions about ordering and using medicines safely.

Whatever you decide, the goal is the same: to help you feel like yourself again, with a plan that fits your life.

General information only — not medical advice. Always read the patient information leaflet and consult a doctor or pharmacist before starting any medication.