Hormone Replacement Therapy (HRT) is the most effective way to manage menopause symptoms, but with so many options available, it can feel a bit overwhelming. Don't worry - we at Syrona Health are here to break it down for you! Let's dive in and explore the different hormones and forms of HRT so you can feel informed and empowered when discussing your treatment plan with your doctor.

Which Hormones Do You Need?

The first step is determining which hormones you need based on your symptoms and medical history. For most women, menopause symptoms are caused by a decline in oestrogen. However, if you still have your womb (i.e. you haven't had a hysterectomy), you'll also need to take progesterone to protect against endometrial cancer. Your doctor can help you decide if you need oestrogen, progesterone, or both.

Oestrogen can be taken in various forms, including tablets, patches, gels, sprays, and vaginal creams/rings/pessaries. If progesterone is needed, it's available as capsules, a patch (in combination HRT), a hormonal coil, or vaginal capsules.

Cyclical vs. Continuous HRT

If your last period was less than a year ago, your doctor may recommend sequential or cyclical HRT, where progesterone is taken at variable doses. This leads to a monthly or quarterly bleed, similar to a period. If it's been over a year since your last period, continuous HRT with a steady dose of progesterone may be suggested instead. With continuous HRT, you shouldn't experience any bleeding.

What About Testosterone?

Testosterone is a newer addition to menopause treatment. In the UK, it's currently only recommended for women with reduced sexual desire if standard HRT hasn't helped. However, evidence is growing for its potential benefits. If testosterone is suitable for you, it can be prescribed as a gel or cream, but this is an "off-label" use that requires extra caution and expertise from your doctor.

Choosing Between Systemic and Local HRT

HRT can be broadly categorised into two types:

1. Systemic HRT: Absorbed into the bloodstream to treat whole-body symptoms
2. Vaginal oestrogen: Applied locally to alleviate vaginal, vulval, or urinary symptoms

Tablets, patches, and gels are examples of systemic HRT, while vaginal creams, pessaries, and rings are local treatments. Many women benefit from a combination of both systemic and local HRT.

Are There Risks to Consider?

While HRT is very safe for most women, there are a few factors to keep in mind:

• Tablets are associated with a slightly higher risk of blood clots compared to patches and gels
• Certain types of progesterone (like Provera) may carry a higher breast cancer risk than micronised progesterone (Utrogestan)

Your doctor can help you weigh the benefits and risks to make an informed decision. At Syrona Health, we believe every woman deserves personalised, high-quality menopause care. By understanding your HRT options, you can take control of your symptoms and feel your best. Remember, we're always here to support you on your menopause journey!