How to stop taking HRT safely
There’s no limit about how long you can take HRT for, so it is important to discuss stopping the medication with your doctor. Many women stop taking HRT after about five years or when their symptoms are no longer a problem.
You can stop HRT immediately, but it is recommended that you gradually reduce your dose over two or three months, especially if you are on a higher dose of oestrogen, to prevent the menopausal symptoms returning.
If you’re taking a low dose of oestrogen the gradual reduction may not be required. On stopping, many women have a return of their menopausal symptoms but these are often mild and resolve in time with no treatment.
If your symptoms are severe when you stop then you need to discuss this matter with your GP who may prescribe a low dose HRT. Your doctor will need to consider your individual risk.
After stopping many women experience bladder and vaginal symptoms. These can be controlled with creams or pessaries that contain a very low dose oestrogen. These still pose the risks associated with the use of HRT but to a lower extent because very little oestrogen is absorbed into your bloodstream.
Alternatives to HRT
If you decide against taking HRT or can’t due to a medical reason, then there are other ways to manage symptoms of the menopause. These include:
- ensuring you exercise regularly,
- maintain a healthy diet, including cutting down on spicy food and alcohol,
- try antidepressants – certain types can help you with hot flushes and night sweats, although they haven’t had clinical trials for this use.
In recent years, practitioners in some areas have begun to prescribe bio-identical hormones for relief of menopausal symptoms. These are man-made hormones, usually of plant origin and designed to be identical to those produced naturally by the body.
They are available as creams, lozenges, gels and vaginal preparations. They frequently contain a mix of several differing types of oestrogen, progesterone and other sex hormones produced by the body, however there are currently no long-term studies that have been performed on these preparations to look at efficacy and risk.
They are not regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA) and are marketed as natural products. This means they haven’t been through the rigorous process of drug development, which conventional medicines and products usually undergo and therefore haven’t been scientifically evaluated in clinical trials for effectiveness and safety.
Complementary and alternative therapies
Choosing a complementary or alternative therapy is also available:
- Herbal treatments
These have all been reported as being helpful during menopause. As well as the use of vaginal lubricants which can help to overcome vaginal dryness and soreness in some women.
Plant extracts such as St John’s wort may help reduce night sweats and red clover can be used to help alleviate symptoms associated with the decline in oestrogen production4. It’s however worth highlighting, that research studies have shown red clover needs to be taken up to 6 months before any main relief is felt.
Cognitive behavioural therapy (CBT) is also another potential option, as it can help some of the symptoms such as low moods or anxiety caused by the menopause; as well as insomnia and some physical symptoms such as joint pain.5
Menopausal women may feel overwhelmed with the symptoms they can experience leading up to and during the menopause and feel unsure on what treatment option is for them. Try keeping a symptom diary and make a note each day of how you’re feeling, scoring any symptoms according to how bad you’re finding them. This can help form the basis of a chat with your GP, or menopause specialist, and they can help look at ways these can be managed and treated.
Remember, friends and family can help support too or just be there to listen when you need them.
>Read more: How can you help support someone through the menopause?
- Hormone Replacement Therapy – England – April 2015 to June 2022 - NHS
- About hormone replacement therapy (HRT) – NHS UK
- HRT Guide - British Menopause Society
- Herbal remedies and complementary medicines for menopause symptoms - NHS
- Treatment - NHS