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Menopausal hormone therapy

If menopausal symptoms are affecting your quality of life, it’s important to get help. Symptoms may include hot flushes, night sweats, aches and pains, vaginal dryness and mood changes. There are many ways to manage your symptoms, but no other treatment has been shown to be as effective as menopausal hormone therapy (MHT).

What is MHT and how does it help?

MHT is the replacement of female hormones oestrogen and progesterone, and sometimes testosterone. This hormone therapy must be prescribed by your doctor. MHT helps to reduce menopausal symptoms that are caused by lower levels of oestrogen hormones before and after menopause. MHT may also help reduce health risks such as osteoporosis and heart disease.

Is MHT safe?

Research shows MHT is a safe and effective treatment for menopausal symptoms for healthy women. MHT has low risks for women aged between 50 and 60, or when used within 10 years of their final period.

There may be some risks associated with MHT, depending on your individual situation. For example, your age, medical history, family history, when you start the medicine, how long you use it, and the type and dose of medicine taken.

The risk of blood clots, stroke or breast cancer due to taking MHT is small but may increase if you have other risk factors, such as smoking or being overweight.

Possible side effects

Everyone responds differently to MHT. Some women may not experience any side effects, while others might have symptoms such as nausea, fluid retention, vaginal bleeding or sore breasts. Most symptoms settle within the first three months.

Who should not use MHT?

It’s recommended you do not start MHT if you are older than 60 or if you’ve been postmenopausal for 10 years or more.

MHT is not recommended if you have had hormone-dependent cancer. Your doctor may also advise you not to use MHT if it could increase your health risks. For example, if you have undiagnosed vaginal bleeding or heart disease.

Types of MHT

Oestrogen and progesterone

Oestrogen is the main hormone prescribed to relieve menopausal symptoms. If you’ve had a hysterectomy, oestrogen may be all you need. If you haven’t had a hysterectomy, oestrogen and progesterone are used together, as progesterone reduces the risk of endometrial cancer (cancer of the uterus).


Tibolone is a synthetic hormone that has oestrogen, progesterone and testosterone effects. Some women find Tibolone helps with menopausal symptoms and mood. It may also help with sexual desire (libido).


Testosterone therapy is only recommended for postmenopausal women who are distressed by their loss of sexual desire. This condition is known as hypoactive sexual desire disorder (HSDD).

How do you take MHT?

MHT can be taken in various doses and forms, including pills, patches, gels, vaginal pessaries, creams and tablets. If your only symptom is vaginal dryness or pain during sex, you can try vaginal oestrogen cream.

How long do you need to take MHT?

Once you’ve found the right type and dose of MHT, you can take it for as long as you need. Many women have symptoms for about eight years and one in four women have symptoms into their 60s and 70s.

When to see your doctor

Talk to your doctor about therapy options and risks. It’s important to see your doctor for a review each year.

For more information, resources and references, visit the Jean Hailes menopause web page.