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World Menopause Day - Hormone Replacement Therapy (HRT)

18 October 2024

October is Menopause awareness month, with World Menopause Day being held on 18^th October. The purpose of the day is to raise awareness of the menopause and the support options available for improving health and wellbeing.

The theme for World Menopause Day 2024 is Hormone Replacement Therapy (HRT). Though menopause and hormone replacement therapy are well understood in some parts of the world, they still receive little attention or remain controversial in others. This is the reason why International Menopause Society (IMS) chose it as the official theme of this year's World Menopause Day.

It is estimated that of the 33million people employed in the UK, nearly 6 million of those are experiencing menopause.

Menopause can have a huge impact on people's lives: 3 in 4 experience symptoms and 70& experience stress as a result. These people are also often at the peak of their professional careers, yet 14% go part-time and 10% actually leave work.

Menopause and perimenopause symptoms can have a big impact on your daily life, including relationships, social life, family life and work. It can feel different for everyone. You may have a number of symptoms or none.

Symptoms usually start months or years before your periods stop. This is called the perimenopause

Changes to your periods: the first sign of the perimenopause is usually, but not always, a change in the normal pattern of your periods. Eventually you will stop having periods altogether.
Mental health symptoms: commonly include changed to your mood, like low mood, anxiety, mood swings, low self-esteem or problems with memory or concentration (brain fog)
Physical symptoms: commonly include, hot flushes, difficulty sleeping, night sweats, palpitations, headaches, muscle aches and joint pains, change in body shape, weight gain, skin changes including dry and itchy skin, reduced sex drive, vaginal dryness and pain, itching or discomfort during sex, recurrent urinary tract infections.

Symptoms can last for month or years and can change with time. Some symptoms such as joint pain and vaginal dryness can carry on after your period stops.

Getting advice early can get reduce the impact perimenopause and menopause have on your health, relationships and work.

The 5 W's of Hormone Replacement Therapy (HRT)

Through this guide you will learn about the 5W's, Who, What, When Why and Where of HRT to guide you no matter where you are in the world.

Who is HRT for? Your healthcare professional (e.g. GP, nurse etc) may offer you HRT if you are dealing with symptoms that affect your daily life. It can help with hot flushes, night sweats, vaginal dryness and urinary symptoms. It is also recommended for premature ovarian insufficiency and early menopause.

Who might NOT need it? Women go through menopause at the natural age (after 45) and have no bothersome symptoms usually don't need HRT. Some people believe HRT is a "fountain of youth", but there is little scientific evidence for that. It is important to remember HRT is not recommended solely to prevent aging, memory loss or dementia.

Women with existing medical conditions: Women with certain medical histories such as breast cancer and blood clots should talk to their healthcare professional about whether HRT is safe for them. Deciding to use HRT is a personal choice and should involve discussions about the benefits and risks with a healthcare professional who knows your health history.

What is HRT? HRT supplements the hormones your body stops making after menopause. These hormones, particularly estrogen and progrestrone are crucial for managing menopause symptoms and protecting your health. HRT can be taken in tablets, patches, sprays, gels, vaginal creams, gels and rings.

Estrogen: the main hormone used in HRT. It helps reduce hot flushes, night sweats and vaginal dryness

Progesterone: this is given to women who still have a uterus (womb). It helps protect the womb lining from growing too much when taking estrogen.

When should HRT be started and stopped:

When to start:

Symptom relief: HRT can be started when menopause symptoms like hot flushes and night sweats begin to interfere with daily life.

Early menopause and premature ovarian insufficiency: starting HRT as soon as possible is recommended to reduce the risk of long term health problems like bone thinning (osteoporosis) and heart disease.

When to stop:

There is no set rule for when to stop HRT: Some women use it for only a few years, while others may need it longer. It is important to regularly check with your healthcare professional to see if continuing HRT is the right choice for you.

Long term use: may carry certain small risks such as increased chance of breast cancer or blood clots. Your healthcare professional will help weigh these risks against the benefits based on your personal health history, you should at least have an annual discussion of this risk : benefit balance.

Why is HRT important? HRT helps women manage the challenging symptoms of menopause and protects against conditions that become more common after menopause such as:

Hot flushes and night sweats: the most common and often disruptive symptoms of menopause.

Vaginal symptoms: such as dryness or discomfort, which can affect sexual health and quality of life.

Bone health: HRT helps protect against osteoporosis, a condition that weakens bones and can lead to fractures.

Heart health: for some women, HRT may lower the risk of heart disease, especially when started close to the time of the menopause transition.

Where can you get HRT? HRT is available through your healthcare professional, but access may depend on where you live.

Further details of these and the 5W's of HRT can be found on International Menopause Society

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