Which therapy is most effective in treating the symptoms of menopause?
The most common treatment for decades has been Hormone Replacement Therapy (HRT), and for some women it’s perfect. Others however prefer to try to manage it differently, either through alternative options like bio-identical hormones or complementary therapies (instead of, or in addition to HRT, as long as they’re not contraindicated).
Hormone replacement therapy (HRT) is often considered by doctors to be the most effective treatment option for relieving menopausal symptoms, especially hot flushes. For many women this proves to be the path they are happiest to take. The type of HRT and the dose that’s recommended will depend in part on a person’s individual and family medical history, or whether it’s suitable at all. In some cases, it’s contraindicated.
There are two main hormones used in HRT: oestrogen and progestogen. They either come as a combined hormonal therapy or oestrogen only.
- Combined HRT: More commonly recommended, especially for continued use for women who are postmenopausal.
- Oestrogen-only HRT: This is usually only recommended if an individual has had a hysterectomy. It’s also sometimes recommended for women going through menopause before the age of 45.
HRT is either taken as a tablet, in the form of skin patches, oestrogen gel, implants or as vaginal oestrogen. These tend to be in either cyclical or sequential routines. You can find out more on the NHS website. You might also be given a testosterone gel if you find HRT does not improve your libido.
Bio-identical hormone replacement therapy (BHRT):
There is also a rise in interest in bio-identical hormones, which are essentially man-made hormones, similar to those produced by the human body. The impact is largely the same as HRT - it helps to relieve symptoms of menopause such as hot flushes or night sweats. This is a relatively new area and as with all new things you do need to be careful what you’re getting and where you’re getting it from. On balance in the UK, they are not recommended by the powers that be.
- rBHRT - Regulated Bioidentical Hormone Replacement Therapy - is authorised by the regulators such as the MHRA in the UK.
- cBHRT - Compounded Bioidentical Hormone Replacement Therapy - usually in the form of creams or gels - are not recommended or regulated in the UK. In fact, a study in 2019 deemed them unsafe.