HRT side effects & how to deal with them

Although many women do not report any issues with HRT, side effects can occur. These can depend on the type of hormone, dose, and how it is given, such as on the skin, orally, or vaginally. Factors such as how the woman metabolises hormones and sensitivity to fluctuation in hormones or skin issues can impact side effects. Hormone and menopause specialist Dr. Katie Hodgkinson provides her expert advice on coming off HRT safely.

Common side effects of HRT

Here are examples of side effects of HRT:

How long do HRT side effects last?

Most side effects are short-term, such as bloating, breast tenderness, or mild mood changes, and usually subside with time or HRT dose adjustments. 

Some women are sensitive to progestin (synthetic progesterone) and, in some cases, body-identical progesterone (commonly prescribed as part of HRT), and adjustments to the dose, how the medication is taken or changing the medication may be advised. 

Long-term effects related to heart disease risk, bone density, or liver health require monitoring. You may be interested in reading 'Top 10 questions about HRT answered'.

How can I manage menopause without HRT? 

Some women do not take HRT through personal choice or may be unable to take it due to health reasons or have not tolerated it. Lifestyle adjustments and non-hormonal medication or supplements can help to manage symptoms of menopause and support health risks.

Here are examples of this:

• Regular exercise.
• Healthy balanced diet.
• Achieving weight within a normal range.
• Sleep hygiene: e.g. regular bed-times, limiting caffeine until several hours before bed, limiting alcohol, minimising screen time in the evenings, breathing exercises
• Managing hot flushes: limiting alcohol / caffeine / refined sugar / spicy food, good hydration, layered clothing, relaxation and cooling techniques. 
• Vaginal health: vaginal lubricants or local oestrogen therapy (if safe and able to take). You may be interested in reading about vaginal atrophy or vaginal dryness.
• Stress and mood: Mindfulness / meditation, therapy, breathing exercises or support groups to manage anxiety and irritability.
• Bone health: weight-bearing exercises, calcium-rich foods and vitamin D
• Non-hormonal medications / supplements.

If you are considering coming off HRT, when and how to come off HRT should be an individual and medical decision and carefully done where possible to minimise symptoms recurring and to address any health risk factors. Continue learning about coming off hrt safely. Continue learning about coming off HRT safely. 

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