WHAT SHOULD YOU KNOWABOUT HRT
- I’ve decided to try HRT after discussing my situation with my doctor. Is there any particular time after menopause when it’s best to start?
If you are having menopausal symptoms that interfere with your quality of life, you can start on HRT at any time. If the main reason for HRT is your worry about a high risk of osteoporosis or heart disease in the future, it’s best to start on it within about twelve months of your menopause. It’s also acceptable to begin at any time after the menopausal years. For example, a woman in her late sixties whose bone density is found to be critically low can start HRT to prevent any further loss of calcium from her bones.
- My periods are getting less regular and I’m wondering whether there’s any sense in starting HRT before they finally stop. Could I avoid menopausal symptoms by doing this, for example?
This is not recommended, because many women don’t develop any significant menopausal symptoms and are not at risk of heart disease or osteoporosis, the other main reason for having HRT Another reason why we don’t normally offer HRT before menopause is that women could end up with persistently high levels-of oestrogen, and we don’t know the effects of this yet.
- How long should I stay on HRT?
That depends on why you are having it. If it’s to control symptoms, you’ll probably need HRT for between two and ten years, depending on how long the symptoms last. If it’s for protection of your bones, heart and blood vessels, your doctor will probably recommend that you stay on HRT until your late sixties or early seventies, or for the rest of your life.
- When should I stop HRT for symptom control?
When you feel comfortable about it. If you don’t want to go on any longer because it gives you side effects, or you feel well and are reluctant to continue taking pills, using patches or whatever, it’s a good idea to see how you get on without them. If you do stop HRT, the dose of hormones should be gradually reduced.
- Should I take my HRT pills at the same time each day?
Yes. This seems to give better control of symptoms and reduces the likelihood of spotting.
- Will I need to change the type of HRT I’m on, or the dosage, as time goes by, even though it seems to suit me well?
No. Once a hormone format is found that suits a particular woman’s needs, she is usually advised to stay with that format unless an alternative is developed that is likely to suit her better. Your dosage will probably also remain unchanged unless you have unwanted side effects at some stage.
- Can I use a hormone-based vaginal cream if I’m already using an oestrogen patch?
A vaginal cream used twice a week together with a patch may be called for if vaginal dryness is particularly troublesome and the oestrogen patch on its own does not do the trick.
- Do I need to remove my HRT patch when I shower or swim? Patches are designed to withstand the sorts of activities you describe, but if you find there is a problem, remove it from your skin and replace it on its original backing while you shower or swim. When you’ve dried off, put it back on again.
- Is there any evidence that HRT reduces the risk of bowel cancer?
Several studies suggest that oestrogen confers substantial protection against bowel cancer, while at least one other well-designed study has not reproduced this finding. Various groups of researchers are currently attempting to come up with a conclusive answer to this important question.
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