The symptoms of the menopause are most commonly treated using hormone replacement therapy (HRT), which is designed to boost the hormones that are reduced during menopause. You’ll usually start taking HRT as soon as you begin experiencing menopausal symptoms.
But with a range of available HRT treatments, which is the right option for you? Here, we evaluate two of the most common HRT types — HRT patches and HRT pills — to help you understand which treatment is most suitable for you.
Of course, you should always have an honest discussion with your doctor first, who will recommend the most appropriate HRT treatment based on your symptoms.
What is HRT?
As the name suggests, hormone replacement therapy (sometimes referred to as menopausal hormone therapy or MHT) is a treatment designed to replace the female hormones — namely oestrogen and progesterone — which are naturally reduced as a woman reaches menopause. By increasing these hormones to their natural levels, HRT helps to reduce and manage the symptoms of menopause.
Most women can take HRT if they're suffering symptoms associated with the menopause, although it may not be suitable for everyone. For instance, a doctor may not recommend HRT if you:
- Have a history of breast, ovarian or womb cancer
- Have a history of blood clots
- Have liver disease
- Have high blood pressure — this will need to be addressed before you can start HRT
- Are pregnant — it's still possible to get pregnant while taking HRT, so you should use contraception for at least 1 year after your last period
Most women will take a combined HRT (which includes oestrogen and progesterone), although women without a womb (because they’ve had a hysterectomy, for instance) will be prescribed an oestrogen-only HRT.
HRT treatments compared
HRT treatments come in many forms — including patches, tablets, gels, and sprays — and your GP will recommend the best course of treatment based on your symptoms and medical history. Here, we’re going to focus on HRT patches and HRT tablets to help you understand more about these common HRT treatment methods.
HRT patches are small adhesive ‘stickers’ that are embedded with hormones to enable them to be absorbed directly into the skin. They’re usually applied to the lower abdomen (just below the waistline) and provide relief from the most common symptoms of the menopause. Each patch is worn continuously and should be changed twice weekly.
HRT patches come in two forms:
- Continuous combined HRT patches — these contain both oestrogen and progesterone and include Evorel Conti Patches and FemSeven Conti Patches.
- Oestrogen-only HRT patches — these are typically prescribed for women without a womb and include Evorel Patches, Estradot Patches and FemSeven Patches.
Why use HRT patches?
Some doctors believe it’s preferable for hormones to be absorbed through the skin — thereby avoiding the liver — and therefore it may be that patches are more effective in treating the symptoms of your menopause than an oral treatment.
HRT patches are a safer option for those with a higher risk of blood clots or strokes — for example, if you smoke, you’re overweight, or you suffer from frequent migraines — and therefore they may be preferable to HRT tablets where this is the case.
Side effects of HRT patches:
Side effects are rare with HRT patches, but some women may experience the following when using them:
- Weight gain
- Breast pain
- Skin irritation
- Menstrual pain
If you’re concerned about any side effects you may experience while using HRT patches — particularly any symptoms not listed above — you should consult a GP or pharmacist.
HRT tablets are an oral form of HRT medication designed to treat the symptoms of the menopause. Most HRT tablets are taken with water once daily — for them to be most effective, they should be taken at the same time each day. They come in a range of different types and strengths.
Like HRT patches, there are typically two types of oral HRT treatments:
- Continuous combined HRT tablets — these contain both oestrogen and progesterone and include Elleste Duet Tablets, Kliofem Tablets, and Premique Low-Dose Tablets.
- Oestrogen-only HRT tablets — these are typically prescribed for women without a womb and include Elleste Solo Tablets and Premarin Tablets.
Why use HRT tablets?
HRT tablets are the easiest most common way of taking HRT treatment, and they have been shown to reduce — and in some cases prevent — the most common symptoms of the menopause, including hot flushes, night sweats, vaginal dryness, and mood swings.
You are recommended to take HRT in tablet form if you do not have a history of heart disease, strokes, or liver problems, as the tablets can slightly increase your risk of these conditions.
Side effects of HRT tablets:
As with HRT patches, side effects of HRT tablets are rare, but some women may experience the following when taking them:
- Weight gain
- Nausea and headaches
- Breast pain
- Stomach cramps and diarrhoea
- Skin irritation
- Back pain
- Discharge from the vagina
As with all HRT treatments, you should consult a GP or pharmacist if you experience any side effects that you’re concerned about.
Other HRT treatments
Of course, patches and tablets aren’t the only available forms of HRT treatment. There are a number of different options that your doctor may recommend. Alternative treatments include:
- HRT gels. An HRT gel such as Sandrena Gel or Oestrogel is applied directly to the skin. Sandrena and oestrogel contains estradiol — a bioidentical form of oestrogen — to boost the body’s oestrogen levels and relieve menopausal symptoms such as hot flushes, vaginal dryness, and night sweats.
- HRT sprays. A spray treatment such as Lenzetto Spray also contains estradiol and is sprayed directly onto the skin to boost oestrogen levels when absorbed. It can provide relief from a number of menopausal symptoms including hot flushes, night sweats, and mood swings.
To address vaginal dryness specifically, you can also use vaginal hormone pessaries or creams. Vaginal hormone treatments such as Vagifem or Ovestin increase vaginal oestrogen levels and keep the vagina hydrated and free from irritation. You can also use these alongside a non-HRT cream treatment such as Vagisan MoistCream, which is applied directly to the vagina to relieve irritation and discomfort. This hormone-free treatment can be used in conjunction with HRT.
Which HRT treatment is right for me?
Finding a suitable HRT treatment can take time. There are several treatment options available, so it’s important to discuss your symptoms and your medical history with your doctor so they can determine the most appropriate type of treatment.
There’s not a vast difference between taking HRT tablets and using HRT tablets when it comes to managing menopausal symptoms, so it largely depends on your preference — in combination with the advice of your doctor, of course.
It’s also important to remember that — in addition to HRT, or if you decide that HRT is not for you — making a series of lifestyle changes can help alleviate the symptoms of menopause. These include:
- Exercising regularly. Regular exercise has been shown to reduce the risk of hot flushes, while it’ll also improve sleep quality and boost your mood.
- Staying cool at night. Sleeping in a well-ventilated room and wearing loose clothing in bed will keep you cool and help to relieve hot flushes and night sweats.
- Reducing alcohol and caffeine intake. Consuming alcohol and caffeine regularly can increase the likelihood of hot flushes, so try to limit your intake of these.
- Avoiding spicy foods. Eating spicy food is a known trigger of hot flushes, so cutting back on spicy dishes will help to reduce the likelihood of experiencing them.
- Looking after your mental wellbeing. The menopause can often impact your mood, so try to reduce stress by engaging in mindful activities such as yoga or meditation.
- Taking herbal supplements. You can speak to your doctor about taking herbal supplements or complementary medications to provide additional relief from your symptoms.
- Stopping smoking. If you’re a smoker, quitting will help to reduce hot flushes, while it also has ample other health benefits such as cutting your risk of heart disease or cancer.
If you’re suffering from the symptoms of the menopause, there are a range of treatment options available along with a number of effective at-home remedies. Consult your doctor or visit our Menopause (HRT) page today to explore whether HRT patches, HRT tablets, or another treatment option may be suitable for you.