Taking hormone-based medications for early menopause

Hormone-based therapies for early menopause (EM) include oestrogen-based therapies (Hormone Replacement Therapy (also known as Menopause Hormone Therapy), hormonal contraception, and testosterone (androgen) therapy. These therapies work differently and therefore suit women in different circumstances, but they can ease the symptoms of EM. Oestrogen-based therapies may help reduce long-term health risks such as osteoporosis and heart disease.

Women with EM able to take HRT are advised to do so until at least age 50, unless they have experienced oestrogen sensitive cancer (e.g. breast and endometrial) (see Non-hormone based medications for early menopause)

Taking HRT: finding the right form and dose

HRT can be taken in a variety of forms and can contain different hormones in a range of combinations and doses. Finding the right dose and form of HRT can take time. Some women found a form of HRT that suited them relatively quickly. They described finding it helpful in reducing symptoms such as hot flushes, night sweats, sleep problems and fatigue, moodiness, vaginal dryness and loss of libido. Some described HRT as ‘amazing’ or saying it made them feel like their ‘old self’.

For Lorena, finally finding the right HRT meant she felt ‘normal again’.

Other women described undergoing a long process of ‘trial and error’ before finding the ‘right’ medication (or combination of different medications) and dose. Some women mentioned eventually giving up searching for the ‘right kind of HRT’, particularly if they felt unsupported by health practitioners.

Anna, who was diagnosed with spontaneous EM at 35, shared her experience of trying many different combinations of HRT. The process eventually ‘wore her down’ and she stopped taking HRT.

Other women found that while HRT helped their symptoms, they still didn’t feel the same as before EM. For Debra, HRT made life ‘pretty manageable’, but it didn’t ‘fix everything.’

Julia, who experienced EM as a result of treatment for Hodgkin’s Lymphoma, said even after finding a form of HRT that suited her, she still felt something was ‘missing’.

Types of HRT women took

The women we talked to took a range of forms of ‘systemic’ HRT (which affects the whole body). Most women were taking combination HRT (oestrogen and progesterone), and some women who had had a hysterectomy were taking oestrogen-only HRT. A few women took vaginal oestrogen for vaginal dryness. Types of hormonal contraception women mentioned included oral contraceptive pills, hormone-releasing IUDs or low-dose vaginal contraceptive rings.

After learning she had Lynch Syndrome, Tracey had her ovaries and fallopian tubes surgically removed to reduce her risk of ovarian and other cancers. She explained how her oestrogen patches worked.

Side effects

A few women mentioned experiencing side-effects from HRT, including migraines, moodiness, increased breast size, heart palpitations, pimples, weight gain, or skin reactions to patches. For some, side-effects disappeared when they took a different form of HRT, but a few, unable to find a form of HRT that suited them, stopped taking it.

Natalie decided to stop taking HRT because of the side-effects she experienced.

Testosterone therapy

A few women mentioned taking testosterone therapy (in combination with oestrogen-based therapies) to assist with low libido.

Mary found testosterone cream in combination with systemic HRT ‘phenomenally’ improved her interest in and enjoyment of sex.

Anna discussed her experiences of using testosterone cream in combination with an oestrogen implant.

Accessing HRT

A couple of women noted that they had experienced occasional problems accessing HRT due to stock shortages. For women who found HRT very helpful, supply disruptions could be frustrating. As Tracey said: ‘I’m happy to make an uproar if that continues and I have issues accessing them. [laughing] You’ll see me on the front page of the paper!’

Melinda said the possibility of not being able to access HRT was ‘confronting’. She shared what she had learned about supply issues from her pharmacist and endocrinologist.

Further information:

Talking Points (Women)

Talking Points (Health Practitioners)

Other Resources