Risks of hormone replacement therapy

Hormone replacement therapy (HRT) is a popular form of treatment for the menopause. It is available in different forms, e.g. oestrogen only HRT and restores decreased hormone levels.

But there are risks and side effects of HRT. This has caused a great deal of controversy over the past few years with claims being made for increased risk of cancer, heart disease and strokes.

If you are going through the menopause and are thinking about HRT then it is important that you familiarise yourself with the risks as well as the benefits.

The benefits of HRT are discussed separately.

There are many different views regarding HRT and at the end of the day only you can make the decision whether to take it or not. So it is a good idea to learn as much as you can about HRT, talk to others who have taken it, speak to your GP and read about it on this website.

There are side effects from taking HRT but this is a common feature of any form of medication. Everyone reacts differently and it is hard to predict a person’s reaction to a particular medicine.

There is an issue surrounding the length of time you take HRT for and the risks associated with this. It appears to be the case that using HRT on a short term basis, e.g. for no more than 5 years is unlikely to cause any long term problems and can be considered safe to do so.

But there are risks associated with long term use.

Long term use is classed as more than 5 years.

Side effects of HRT

These include:

• Sore/tender breasts
• Water retention
• Heavy periods
• Weight gain (although this may be due to lifestyle reasons)
• Nausea
• Depression
• Headaches
• Indigestion
• Aches and pains
• Acne

These side effects vary according to the type of HRT you are taking. They will differ between the oestrogen only HRT to the combined form of HRT.

Your GP will discuss these with you.

If you experience any of these then your GP will look at changing the type of HRT you are using to a different type of oestrogen/progesterone; the dosage or the way you take it, e.g. swap the patch for an implant.

A few lifestyle changes can help such as following a low fat diet which is also high in carbohydrates and taking regular exercise.

Risks of HRT

This is the issue which concerns many people. They include:

• Increased risk of breast cancer
• Increased risk of ovarian cancer
• Increased risk of heart disease
• Increased risk of a stroke
• Increased risk of gallstones
• Increased risk of deep vein thrombosis

There is a slight risk of these conditions as a result of taking HRT but very often, the benefits outweigh the risks.

You need to weigh up both of these before making your decision.

If you are advised against HRT then it will be for very good reasons. Your GP will have looked at your medical/family history and your menopausal symptoms at present before making his/her decision.

There are alternatives to HRT which are discussed in a separate section.