The rationale for hormonal replacement therapy is not only to treat symptoms and improve quality of life but also to minimise the impact of chronic diseases such as cardiovascular disease and osteoporosis.
A major opportunity exists at the onset of the menopause to identify longer-term health risks and initiate prevention strategies.
Oestrogen replacement can be taken in the form of tablets, patches, gels or sprays. It can also be administered vaginally, which is useful for local urogenital symptoms.
A second important hormone is progesterone. If we give oestrogen alone in women with a uterus it can thicken the lining of the uterus leading to an increased risk of endometrial cancer. The progesterone can also be administered via a tablet, patch or a Mirena coil. Other hormones, such as testosterone can be considered for women with persistent troublesome low libido.
There are very few absolute contraindications to HRT treatment but there are some indications when HRT needs to be prescribed with caution. In these cases, or for those wanting to avoid HRT, non-hormonal alternatives can be used.
Alternative remedies, cognitive behavioural therapy and lifestyle intervention such as diet, exercise, smoking cessation, alcohol reduction and stress management all play an equally important role.
At the Agora, we see women who are worried that they might be entering the menopause, as well as those who have reached the menopause and are confused about the treatment options that are available to relieve symptoms and maintain their long-term health.
For people who do need treatment, or who are worried about their long-term health, we can offer advice about the advantages and risks of hormone replacement therapy (HRT), as well as a diet and lifestyle programme to help reduce symptoms. We also offer advice about fertility services available for women who have had a premature menopause.
