Menopause and Hormone Replacement Therapy

Menopause is a natural stage of a woman's life and is marked by the ending of menstruation. A woman's ovarian function usually starts to decline when she reaches 45 to 55 years of age. Eventually her ovaries stop to produce female hormones. When there is no menstruation for 1year, the woman has reached menopause. Some women will have symptoms e.g. hot flushes, night sweats, sleep disturbances and general irritability.

Hormone Replacement Therapy (HRT) can be used to reduce these symptoms of menopause, but it can also have serious side effects. One should discuss the risks and benefits with her doctor before making a decision.

Conditions not suitable for HRT

  • Allergy to HRT
  • Undiagnosed abnormal vaginal bleeding
  • Venous thrombosis
  • Acute liver disease
  • Breast or womb cancers
  • Established heart disease

Benefits and risks of HRT

  • Perimenopausal symptoms - reduces hot flushes, night sweats.
  • Osteoporosis - prevents osteoporosis, but once oestrogen treatment is stopped, protection against bone loss is largely lost.
  • Improvement in quality of life - improves memory, verbal reasoning.
  • Colon cancer- risk is reduced.
  • Breast cancer - long term intake increases the risk.
  • Endometrial cancer- for women with intact uterus, risk is increased if oestrogen is taken alone.
  • Venous thrombosis - risk is increased.
  • Coronary heart diseases - HRT should not be started in women with established heart disease. There is still inadequate data to show that for women who started hormone replacement therapy closer to their menopause will reduce their chance of having coronary heart disease.

HRT preparations

It is either oestrogen only, progestogen only or a combination of oestrogen and progestogen.

They can come in forms of tablets, patches, gel and vaginal cream. Please discuss with your doctor to choose the most appropriate preparation.

Common side effects

  • Bleeding - for women with intact uterus, HRT may bring back menstrual-like bleeding
  • Breast sensitivity or engorgement
  • Fluid retention

Regular follow up is required while receiving therapy

For more health information, please call our 24-hour health education hotline (Cantonese, English and Putonghua) at 2833 0111 or visit the website of the Family Health Service of the Department of Health at http://www.fhs.gov.hk.

(Content revised 02/2008)