UK Registered DoctorsHormone replacement therapy side effects and risks explained: What you need to know before starting treatment
Menopause is a natural part of life for anyone who menstruates.
When you reach a certain age, usually around 45-55, your periods stop and your body produces fewer of the sex hormones oestrogen, progesterone and testosterone.
But these aren’t the only effects menopause has on your body.
Many people also experience unpleasant menopause symptoms such as:
- Hot flushes that make you dizzy
- Night sweats and disrupted sleep
- Changes in mental health like mood swings, anxiety and brain fog
- Unusually bad headaches and migraines
- Muscle aches and joint pains
- Changes in body shape and weight gain
- Vaginal dryness and pain
- Reduced sex drive
- Sensitive teeth and other mouth problems
These symptoms can have a serious impact on your quality of life.
That’s why women throughout the UK manage their symptoms with hormone replacement therapy (HRT).
Hormone therapy is a menopause treatment that replenishes your sex hormones to regular levels and helps restore your body’s natural functions.
It is effective and generally safe, and even provides some protection against heart disease and osteoporosis (bone thinning).
But there’s one question that many suffering women wrestle with: is HRT safe?
As with any medical treatment, there are some side effects and risks of HRT that you should be aware of.
Understanding HRT safety lets you make informed decisions about your healthcare and balance symptom relief with potential risk to achieve the right outcomes for you.
Before we look into HRT risks and side effects, rest assured that your doctor will only prescribe HRT medication if the benefits greatly outweigh the risks.
To find out whether HRT is right for you, register as a patient and start your free online consultation with a UK-licensed doctor at The Online Clinic today.
What are the side effects of HRT?
Most people who undergo HRT experience no side effects at all.
And for those who do, those side effects are often mild and improve quickly as your body gets used to the medication.
Some reported side effects are also the same as menopause symptoms. So there’s a good chance that you’ll experience them whether or not you use HRT.
There are a few different types of HRT, each of which uses different hormones.
Depending on the type you take, you might experience slightly different HRT side effects.
Before we prescribe HRT medication, we ask you to complete a short medical health questionnaire.
This helps your doctor recommend a form of HRT that’ll relieve your menopause symptoms with minimal side effects or risks.
Common side effects of oestrogen-only HRT
Oestrogen-only HRT is recommended if you’ve had a hysterectomy (womb removal).
Common side effects include:
- Feeling sick (nausea)
- Diarrhoea
- Headaches
- Breast pain or tenderness
- Mild rash or itching
- Leg cramps
- Hair loss
- Mood changes, including low mood or depression
Common side effects of combined HRT
If your womb hasn’t been removed, you’ll need to take both oestrogen and progesterone.
Excess oestrogen can cause womb cancer. But progesterone limits the effects of oestrogen, protecting you against the risk.
There are two types of combined HRT:
- Sequential (cyclical) combined HRT: If you still have periods, you take oestrogen every day, with progesterone during the last 10-14 days of your menstrual cycle either every month (regular periods) or every 3 months (irregular periods)
- Continuous combined HRT: If you’re in postmenopause, you take oestrogen and progesterone every day
Combined HRT can present the same common side effects as oestrogen-only HRT.
But it can also cause:
- Changes in your periods
- Unexpected vaginal bleeding or spotting
- Acne
Common side effects of testosterone HRT
Your doctor might recommend testosterone HRT if:
- You’re in postmenopause
- You have low sex drive
- HRT alone hasn’t helped
Side effects are unlikely if your levels of testosterone are kept within the normal female range.
But excess testosterone can cause:
- Unwanted hair growth
- Acne
- Weight gain
The Online Clinic can prescribe testosterone HRT as well as oestrogen-only and combined HRT.
Get a free consultation today to discuss your treatment.
Serious risks of HRT
The risks of HRT are usually incredibly low. And the benefits are highly likely to outweigh them.
But depending on your medical history, you might be more at risk. This is especially true for long-term HRT.
So it’s important to understand the potentially serious risks of HRT before you begin treatment – and to be completely honest with your healthcare provider.
Breast cancer
HRT can very slightly increase the relative risk of breast cancer.
In women aged 50-69 taking HRT for 5 years, research found:
- About 5 extra cases per 1,000 women using oestrogen-only HRT (0.5%)
- About 14 extra cases per 1,000 women using combined sequential HRT (1.4%)
- About 20 extra cases per 1,000 women using combined continuous HRT (2%)
This risk increases the longer you take HRT and the older you are. But once you stop taking it, your risk decreases.
Even if you’re taking HRT, you can significantly lower your risk of breast cancer with lifestyle changes such as:
- Reducing alcohol intake: Women who consume about one drink per day have a 10% increased risk of breast cancer compared to those who don’t drink
- Losing weight: Women who lose 2-4.5 kg have a 13% lower risk than women with stable weight, while those who lose 9 kg or more have a 26% lower risk
- Quitting smoking: Women who quit smoking after being diagnosed with breast cancer are 33% less likely to die from it compared to those who continue to smoke
Blood clots
HRT tablets can increase the risk of deep vein thrombosis (DVT).
DVT is when a blood clot forms in a vein deep in the leg. The clot can travel to your lungs and get stuck.
This is called a pulmonary embolism, and it can be fatal.
But the risk is very low.
In women aged 40-59 who don’t take HRT, DVT occurs in just 50 people per 100,000 (0.05%).
HRT can double or triple this risk. But that only results in 150 cases per 100,000 (0.15%).
And remember, this only applies to HRT tablets.
HRT patches, sprays and gels don’t increase the risk of blood clots at all.
That’s because oestrogen is much safer when absorbed through the skin.
Stroke
HRT tablets – but not patches, sprays or gels – slightly increase the risk of stroke.
In women less than 60 years old, use of HRT tablets results in just two additional strokes per 10,000 person-years of use.
This risk is very low. But it increases greatly for older women.
Your doctor will be able to advise on whether HRT is right for you, and give you an online HRT prescription.
Endometrial cancer
Oestrogen-only HRT increases the risk of endometrial (womb) cancer.
That’s why this type of HRT is only prescribed for women who’ve had their womb removed.
If you haven’t had a hysterectomy, your doctor will prescribe combined oestrogen and progesterone HRT.
Combined HRT doesn’t increase the risk of womb cancer.
So as long as you follow your doctor’s instructions, you don’t need to worry about HRT and cancer of the womb.
Who should not take HRT?
Undergoing HRT can increase the risk of cancer, blood clots and stroke.
So if you already have a history of these conditions or other high-risk factors, your doctor might consider certain types of HRT to be unsafe for you.
And in some cases, they might advise against HRT altogether.
For example, if you have a history of breast cancer or heart attack, it might be best to look for alternative menopause treatments.
But if you have hypertension (high blood pressure), your doctor might be able to prescribe HRT once the issue has been treated.
As part of your free consultation, your doctor at The Online Clinic will ask you to complete a thorough medical health questionnaire.
This will help them determine if HRT is safe for you.
If the benefits are likely to outweigh the risks, your doctor will be able to give you an online prescription for HRT.
Managing the risks of HRT safely
Why personalised treatment matters
The risks of HRT are typically very low.
But they can be significantly higher if you have contraindications (circumstances that make a treatment unsuitable) or are over a certain age.
Getting treatment that’s tailored to your health profile is essential for maximising the benefits of HRT while minimising the risks.
With personalised treatment from the qualified and experienced doctors at The Online Clinic, you can find a solution that helps keep you safe.
The importance of medical assessments and reviews
For most women, HRT is safe.
But your treatment should still be authorised and monitored by a qualified medical practitioner.
When you request an online HRT prescription, we ask you to complete a short medical health questionnaire.
This helps us recommend a suitable HRT treatment based on your specific needs.
As you proceed, you can schedule regular check-ins with your doctor to discuss your response to treatment and any HRT side effects.
Your doctor might advise changing the dose, delivery method or type of treatment to reduce your HRT side effects and help you live free from symptoms.
Correct dosage and treatment term
Using the lowest effective dose for the shortest duration is key to minimising the risks of HRT.
We start you with a low-dose formulation to help your body get used to the medication.
And where possible, we only recommend HRT as a menopause treatment for up to 5 years.
Long-term HRT may be appropriate for persistent, severe symptoms.
Proper medical supervision ensures the right balance between treatment term and symptom relief.
Always choose a qualified and trusted HRT provider
Menopause is a natural process. But for some women, the symptoms are unbearable.
HRT can be an effective treatment. But like any medication it carries side effects and risks.
If you’re considering HRT for menopause, it’s vital to seek treatment through a UK licensed, approved and regulated provider.
You could try to get HRT through the NHS, but there are reports of long waiting times to be seen.
That’s why women throughout the UK rely on The Online Clinic for quick treatment and trusted medical supervision.
With over 20 years’ experience, we’re one of the UK’s most well-established online medical services.
The Online Clinic is regulated by the Care Quality Commission (CQC) to ensure the highest standards of care.
In our latest report from the CQC, we received a rating of Good in all 5 assessed areas. That means our services are performing well and meeting CQC expectations”.
We also have over 13,000 mainly 5-star patient reviews, including those from women who’ve found relief from menopause symptoms through HRT.
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My first experience of using The Online Clinic has been without fault. I've needed to source hormone replacement products which are out of stock in my area through the NHS and was able to successfully go through the consultation process and purchase with The Online Clinic quickly. The dispensing checks and response time have been professional and thorough, and the GP advice knowledgeable and appropriate. I received my item in the post very quickly and am relieved I am able to continue with my treatment despite being told by the local pharmacy that they still cannot fill my script. I will not hesitate to use them again for repeats if needed, and indeed, any other service I may need in future. Ms Hill |
Start your free HRT consultation with The Online Clinic
During normal working hours (07:00 am – 10:00 pm 7 days a week, our UK-licensed doctors handle consultations within just 30-60 minutes.
If approved your medications are dispatched for next working day delivery when you place an order before 3:30 pm Monday to Friday (public holidays excluded).
Register as a patient today and start your free HRT consultation to find out if you’re eligible for medical relief from your menopause symptoms.
HRT side effects and risks frequently asked questions
Can you stop taking HRT if side effects occur?
Yes, you can.
It’s always best to stop taking HRT under medical supervision.
Ideally, your doctor will gradually reduce your dose to avoid withdrawal symptoms.
But in extreme cases, they might advise you to stop taking HRT immediately.
Is HRT riskier than not treating menopause symptoms?
Undergoing HRT is very slightly riskier than not doing so.
But for most healthy women under 60 years old or who begin HRT within 10 years of menopause, the benefits usually outweigh the risks.
Your doctor will evaluate your circumstances and medical history to help you find the safest possible solution.
Is HRT safe long term?
HRT is considered safe when used at the lowest effective dose for the shortest duration needed.
Risks of HRT increase the longer you use it. And these risks can vary with age, medical history and type of HRT.
It’s always best to use HRT under medical supervision.
Can HRT cause cancer?
There’s a small increased risk of breast cancer with HRT.
The risk is greater in combined HRT preparations..
While oestrogen-only HRT can increase the risk of womb cancer, it’s only recommended for women who’ve had their womb removed.
What alternatives are available if you can’t take HRT?
If you can’t take HRT, you can manage menopause symptoms by:
- Exercising regularly
- Eating a healthy diet
- Sleeping in a ventilated room
- Quitting smoking
- Using vaginal lubricant or moisturiser
Your doctor may also prescribe alternative non-hormonal medications.
Stay informed about HRT side effects and risks
NHS
- Side effects of hormone replacement therapy (HRT)
- Side effects of sequential combined HRT
- Side effects of continuous combined HRT
- Benefits and risks of hormone replacement therapy (HRT)
Cleveland Clinic
Cancer Research UK
The Menopause Charity
Blood Pressure UK
