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HORMONAL REPLACEMENT THERAPY: HOW TO TAKE

Women vary enormously in their response to different medications, so what is ‘the most effective type of treatment with the least side effects’ for one woman may be an ineffective type with bad side-effects for another. Fortunately, there are over 20 different ways in which oestrogens and progestogens can be combined into hormone replacement therapy, so with your doctor’s help you should be able to find one that is right for you.

However, there are two factors that may prevent you ever getting that far: one is that the initial side-effects put you off the whole idea of HRT and you decide just to give up without trying different types; the other is that your doctor may be unable or unwilling to suggest alternatives for you. With the best will in the world, no doctor is able to remember every variety of every form of treatment that is available for all his patients, so he has his ‘favourites’ that he uses most of the time because he knows they work well. If one of them doesn’t work, he then has to start referring to the various publications that list different forms of treatment, and just hope that the one he chooses is the right one for that particular patient. Usually, when the average general practitioner suggests that HRT may be the answer to your menopausal problems, he will almost certainly prescribe his ‘favourite’ preparation because his experience has shown it to work with most of his patients. It may well work for you, or it may not. It may relieve your symptoms without producing side-effects, or it may not. However, if this one doesn’t help, another one probably will.

The number and types of HRT preparations available have increased enormously in the last 10 years, and are still increasing each year. Those most commonly used in the UK are in the form of tablets, patches and implants, all available in different strengths. Less commonly used here, but varying in popularity in other countries, are creams, gels, pessaries, suppositories and injections.

Some preparations come as combined ‘calendar packs’ of oestrogen and progestogen, others come with each hormone packed singly. If you are taking a combined pack, and can’t get the balance of oestrogen and progestogen right to give relief of symptoms without side-effects, your doctor can prescribe the hormones separately to get the right dosage of each. Both hormones are available in different strengths from different pharmaceutical companies, which allows great flexibility and should make it possible for you and your doctor to get it right.

With the exception of implants, any treatment can be stopped at any time, or the dosage can quickly be adjusted, but you will probably get a return of menopausal symptoms if you stop suddenly.

The first decision you and your doctor will make is whether HRT is suitable for you at all. The next thing to consider is whether you take HRT in an oral form, that is as tablets, or whether a non-oral route (patch, implant or cream) would be better.

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Related Posts:

• SEX HORMONE LEVELS AFTER MENOPAUSE: OESTROGEN HORMONES
• ALTERNATIVES TO HRT: LACK OF ENERGY, FEELING ‘BLUE’ OR OUT OF SORTS
• CAPS IN KNOWLEDGE: HRT RESEARCHES
• WAYS OF ADMINISTRATING HRT: IMPLANTS