Learn more about menopausal hormone therapy (MHT), the most effective treatment of menopausal symptoms. This fact sheet explains the different types of MHT available and how to find the right treatment for you.
- Menopausal hormone therapy - fact sheet Download pdf
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?
A recent comprehensive review of evidence on MHT found it is a safe and effective treatment for the relief of menopausal symptoms for healthy women. The data showed that MHT had low risks for women aged between 50 and 60 years, 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 the medication is started, how long you use it, and the type and dose of medication 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 years 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). Your doctor may also recommend different combinations of oestrogen and progestogen (including progesterone and other progesterone-like hormones).
Vaginal oestrogen can be used in the form of a cream, pessary or tablet to help treat vulvovaginal atrophy (changes to the vaginal and vulval tissue), dry vagina and pain during sex.
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 libido (sexual desire), due to improved vaginal secretions and elevated mood.
Testosterone therapy is only recommended for postmenopausal women who are distressed by their loss of libido. This condition is known as hypoactive sexual desire disorder (HSDD). A testosterone 1% cream (specifically for women) is now available and approved for use in Australia.
There is no evidence to support using testosterone in premenopausal women for low libido or any other condition, such as low mood or depression.
How do you take MHT?
MHT can be taken in various forms, including pills, patches, gels, vaginal pessaries, creams and tablets. Types and doses vary according to individual needs and responses to MHT.
How long do you need to take MHT?
It can take some time to find the right type and dose of MHT. Once you’ve found the right type and does of MHT, you can take it for as long as you need. Many women have symptoms for around eight years and one in four women have symptoms into their 60s and 70s.
When to see your doctor
It’s important to review your need for therapy, and potential risks, with your doctor each year.
For more information go to jeanhailes.org.au/health-a-z/menopause