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Symptoms & Treatments
- Q: I have high blood pressure – does this mean I cannot take HRT?
A: High blood pressure should be detected and treated before commencing HRT.
After treatment has started regular blood pressure checks should be made.
- Q: Varicose veins – are they a contraindication to treatment?
A: This is generally not a problem associated with taking HRT. Sometimes legs
may feel heavy on when HRT is taken. If this happens, support hose is recommended.
- Q: How long should I stay on HRT?
A: HRT should be taken for relief of menopausal symptoms. The worst of the
symptoms should be over in one to two years but the length of time treatment
is taken depends on the individual and her doctor.
- Q: Do I have to wait until my periods have stopped completely before I start
treatment?
A: If you have irregular periods, with symptoms impinging on your life then
you should be able to take HRT that gives you a regular monthly bleed.
- Q: How long does HRT take to work?
A: Depending on the severity of symptoms- hot flushes and sweats are usually
the first symptoms to improve on HRT- and that could be within 7 to 10 days,
other symptoms will improve after that.
- Q: How do I know which is the right treatment for me?
A: Most GPs will prescribe what they know and trust. Some women may have to
try two to three treatments before getting it right one for them. A trial
of therapy is 3 months of treatment and an assessment should be made at the
end of that time. If you are an insulin dependent diabetic, have irritable
bowel syndrome, or gut problems it would be better to have your treatment
through skin patches rather than tablets.
- Q: What side effects can I expect from HRT?
A: The most common side effects of HRT, when new to treatment, are leg cramps,
nausea and breast tenderness. These are transitory and should improve after
a few weeks. Other common side effects are bloating/fluid retention, headaches,
PMS symptoms, low backache, mood irritability /anxiety and heavy painful bleeds.
- Q: If I stop treatment does this mean the menopause starts again?
A: No- the menopause goes on while you are taking HRT. The only way to find
out if you are symptom free is to come off your treatment. If you have been
taking treatment for less than 5yrs then you can stop at the end of a current
pack. If you have been on treatment for more than 5 years if would be kinder
to yourself to come of treatment slowly by reducing the dose gradually.
- Q: Will I gain weight by taking HRT?
A: See weight-gain leaflet
- Q: What are the risks of developing a blood clot on HRT?
A: The risks of developing a blood clot (DVT) are very low. The general population
risk is 1 in 10,000. This rises to 2 in 10.000 on HRT. If you have a family
history of blood clots or have had one yourself this risk rises to 5 in 10,000.
You should speak to your doctor if you think you are at increased risk.
- Q: What are the contraindications to HRT?
A: The following are the absolute contraindication to HRT. Pregnancy/active
DVT/severe active liver disease/endometrial cancer.
- Q: Contraception – do I need it?
A: It is advisable for a woman to continue with contraception for 2 years
after her final menstrual period if she undergoes the menopause before the
age of 50. If she is over 50 when she has her final period she should continue
with contraception for a further 12 months.
- Q: My hair is thinning – is this common at the menopause?
A: Hair becomes finer and more babylike at the menopause and may get thinner.
There may be other reasons as well for this. Thyroid function and iron levels
should be checked. Other reasons for thinning hair may be due to other medications
or diet.
- Q: What are the alternatives to HRT?
A: For hot flushes - sage capsules or tincture, black cohosh, dong quai, agnus
castus can be used.
Vitamin B6 - 10mg per day for mood irritability. St.Johns Wort for mild depression
as long as no prescription medicines are being taken. Vaginal moisturisers
such as KY jelly, Replens, or Sylk to help with dryness and make intercourse
comfortable.
- Q: My mother had breast cancer in her 70’s – does this mean
that I am at a higher risk if I take HRT?
A: The most common type of breast cancer occurs in women over the age of 50.
If your mother contracted breast cancer in her 70s this does not increase
your risk. Your risks of breast cancer are increased if your mother or sister
contract breast cancer under the age of 45, or you have a link in three generations
of women from your grandmother down.
- Q: Benign breast cysts – are they a contraindication?
A: 9 out of every 10 breast lumps are benign. If you have had several cysts
then a referral to a breast unit should be considered before considering HRT.
- Q: Vaginal dryness in older women – is there a suitable treatment?
A: Vaginal dryness is common in women past the menopause. The symptoms of
dryness, itchiness and soreness can make life miserable. Bathing/showering
without soap, using aqueous cream as a soothing emollient can be helpful.
Weak natural oestrogen creams or pessaries can be used safely and long-term
for this problem. These can be obtained on prescription from your doctor.
- Q: I have a family history of osteoporosis but do not wish to take HRT –
what are the alternatives?
A: After the menopause women are at risk of out bones thinning. If you do
not wish to take HRT then your doctor can prescribe bone protective treatments
that are non-hormonal. These are called
Bisphosphonates.
- Q: Can I take other medications alongside my HRT?
A: You can safely take other prescription medicines with HRT, although you
should remind your doctor that you are taking HRT. You can also take supplements
such as vitamins and minerals.
- Q: I have been prescribed HRT, when should I start it?
A: If you are still having fairly regular periods of your own then you should
start taking your HRT between day one and day 5 of your next period. If you
have not had a period for some time then you can start when you are ready.
- Q: I am going to have an operation soon, do I need to stop my HRT?
A: It is always advisable to check with the hospital or your consultant prior
to surgery. Some surgeons may wish you to stop HRT 6 weeks before surgery.
- Q: Does it matter if I take my treatment morning or night?
A: It does not really matter when you take your medication as long as you
take it at much the same time each day. If you suffer from nausea by taking
your tablet first thing in the morning then it may be wise to take it later
in the evening before bed.
- Q: Can I delay my bleed so that I do have one while on holiday?
A: It is quite safe for one month in the year only to miss the progestogen
phase of your treatment. You
must be sure to take your next cycle of treatment completely.
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