About oestrogen HRT
| Type of medicine | An oestrogen (may also be spelled estrogen) |
| Used for | Hormone replacement therapy (HRT) |
| Also called | Estradiol: Bedol®; Elleste-Solo®; Estraderm®; Estradot®; Evorel®; FemSeven®; Nuvelle®; Oestrogel®; Progynova®; Sandrena®; Zumenon®; Conjugated oestrogens: Premarin® |
| Available as | Tablets, patches and gel |
If you have had your womb (uterus) removed by hysterectomy, you can experience the symptoms women often develop during the menopause, or 'change'. Oestrogen is a female sex hormone that is prescribed to treat a variety of women's health problems, including menopausal symptoms.
After hysterectomy, or during the menopause, your female hormone levels begin to fall. Hormone replacement therapy (HRT) replaces these hormones. This helps to relieve some of the problems associated with the menopause, such as hot flushes, night sweats and vaginal dryness. HRT can also protect against 'thinning' of the bones (osteoporosis), although other treatments are usually preferred for this. Most HRT is a combination of two female hormones, an oestrogen and a progestogen. However, if you have had your womb removed then it is likely that you only need to take oestrogen HRT therapy.
Different types of natural oestrogen are used in HRT preparations. These include conjugated oestrogens and estradiol. HRT is available in several different forms, such as tablets, skin patches and gels. Your doctor will discuss the pros and cons of each formulation with you so that you can make an informed choice about which formulation to use. There are several brands of each of these types of HRT - all deliver a set dose of oestrogen into your bloodstream.
If you have not had your womb removed, it is important that you receive HRT which contains both an oestrogen and a progestogen. Some of the brands mentioned in this leaflet can be prescribed for women with a womb, as long as a progestogen is also prescribed for a number of days each month. Please see the separate medicine leaflet called Oestrogen and progestogen for HRT for more information about this.
Before taking/using oestrogen HRT
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start oestrogen HRT, it is important that your doctor knows:
- If you have migraine-like headaches.
- If you have any unexplained vaginal bleeding.
- If you have had breast cancer or any lumps in your breast, or if a close family member has had breast cancer.
- If you or a close family member have ever had a blood clot in the legs or lungs.
- If you have varicose veins, or any swelling of your veins.
- If you have too much sugar in your blood (diabetes mellitus).
- If you have any problems with the way your liver works.
- If you get angina chest pain, or if you have had a heart attack.
- If you have a rare inherited blood disorder called porphyria.
- If you have ever had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take/use oestrogen HRT
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the specific brand of oestrogen you have been given, and will provide you with a full list of the side-effects which you could experience.
- If you have been prescribed tablets: take one tablet every day. Take your doses at the same time of day, each day. If you forget to take a tablet, read the advice in the manufacturer's leaflet and follow the instructions it gives. You can take the tablets either before or after meals. There are several different brands and strengths of tablet, so each time you collect a new supply from your pharmacy, it's a good idea to check that the tablets are the same as you have had before. If they are different, speak with your pharmacist who will advise you about what to do.
- If you have been prescribed patches: some patches are applied and left on for a whole week (such as FemSeven® and Progynova® TS), whereas other patches are applied twice a week and removed after 3-4 days. Make sure you are clear how often to use the patches you have been prescribed - the instructions for how to use them will be on the label of the pack. Apply the patch to a clean, dry, unbroken area of your skin, preferably to an area below your waist. You should never apply the patches near to your breasts. Each time you use a patch, apply it to a different area so that your skin doesn't become irritated. There are several different strengths of patches, so it is a good idea to check the strength each time you collect a prescription.
- If you have been prescribed gel: the instructions for how much gel to use will be on the label of the pack. Apply the required amount once every day, and allow it to dry for a few minutes before you put on clothes. It is recommended that you apply Oestrogel® to your arms, shoulders or inner thighs, and Sandrena® to an area of skin below your waist, such as your thighs. Never apply the gel to your breasts. You should wash your hands after applying the gel so you do not pass it on accidentally, but do not wash the area you have applied it to for at least one hour, to give it time to work. If you forget to use the gel but it is still within 12 hours of your usual time, apply it as usual and then carry on as before. If it is more than 12 hours since you should have applied the gel then just wait and apply the next dose when it is due.
Getting the most from your treatment
- Please keep your regular appointments with your doctor. This is so your doctor can check on your progress. Report to your doctor any changes in your well-being and lifestyle, and remember to check your breasts regularly for any lumps. You will also be invited to go for regular breast screening and cervical smear tests - it is important that you attend these sessions.
- If you are due to have an operation, please let the person carrying out the surgery know in advance that you are taking HRT. It is likely that you will be advised to stop taking the HRT a few weeks before any major surgery, especially if you are likely to be on bed rest afterwards.
- There are some risks which are associated with HRT - your doctor will discuss the benefits and risks of the treatment with you before you start. The risks are low when small doses of HRT are used for short periods of time, so the benefits of short-term HRT usually outweigh any problems. If used for longer periods of time, the incidence of blood clots, breast cancer, ovarian cancer and possibly heart disease increases. Because of this, the decision to continue HRT needs to be made individually and your progress should be reviewed at least once a year. If you have any concerns at any time, make an appointment to discuss them with your doctor.
- Travelling that involves periods of immobility (more than three hours) can increase the risk of unwanted blood clots, particularly in the legs or lungs. Taking appropriate exercise during long journeys and wearing flight socks (elastic hosiery) can reduce this risk. If you would like more advice about this, speak with your doctor or pharmacist.
- Before you buy any medicines, check with a pharmacist which medicines are safe for you to take alongside oestrogen HRT.
- Please note: HRT treatments are not suitable for preventing pregnancy.
Can oestrogen HRT cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with oestrogen HRT. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
| Oestrogen HRT side-effects | What can I do if I experience this? |
| Feeling sick (nausea) or being sick (vomiting) | Eat simple meals (avoid rich or spicy foods) |
| Headache | Ask your pharmacist to recommend a suitable painkiller. If the headache continues or is unusually severe, speak with your doctor as soon as possible |
| Dry eyes | If you wear contact lenses, ask your optician for advice if this becomes troublesome |
| Stomach cramps, bloating, weight changes, breast tenderness, fluid retention, rash, changes in sexual desire, mood changes, leg cramps, feeling dizzy. Patches can also cause skin irritation | Speak with your doctor if any of these become troublesome |
| Vaginal thrush | Speak with your doctor or pharmacist for advice on a suitable remedy |
If you develop any of the following symptoms, please stop taking/using the HRT and contact your doctor for advice straightaway:
- Sudden chest pain.
- Sudden breathlessness, or if you cough up blood.
- Swelling or pain in a leg.
- Severe stomach ache.
- An unusually severe headache.
- Any yellowing of your skin or the whites of your eyes (jaundice).
If you experience any other symptoms which you think may be due to the treatment, please speak with your doctor or pharmacist for further advice.
How to store oestrogen HRT
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
FAQs
What are the side effects of oestrogen HRT? ›
- bloating.
- breast tenderness or swelling.
- swelling in other parts of the body.
- feeling sick.
- leg cramps.
- headaches.
- indigestion.
- vaginal bleeding.
Hormone replacement therapy (HRT) is medicine used to treat the symptoms of the menopause. It is common to have side effects in the first few months of taking HRT. These usually settle on their own within 6 to 8 weeks. Side effects include weight gain, irregular bleeding, feeling sick (nausea) and skin irritation.
What is a commonly reported side effect of hormonal replacement therapy HRT )? ›However, some main side effects of hormone replacement therapy (HRT) include: Blood clotting. Heart attack or stroke for people with heart conditions. An increased chance of developing breast cancer.
Why are doctors reluctant to prescribe HRT? ›Unfortunately, some doctors and healthcare professionals still believe outdated reports that HRT is linked to cancer, blood clots and heart problems, so they may be reluctant to prescribe HRT.
Which HRT causes least side effects? ›Skin patches
Oestrogen-only and combined HRT patches are available. Skin patches may be a better option than tablets if you find it inconvenient to take a tablet every day. Using patches can also help avoid some side effects of HRT, such as indigestion, and unlike tablets, they do not increase your risk of blood clots.
Hormone replacement therapy (HRT) slightly increases the risk of breast cancer, ovarian cancer, and sometimes womb cancer. But the risk is small.
What are bad reactions to HRT? ›Side effects related to the hormone Oestrogen – breast tenderness, leg cramps, skin irritation, bloating, indigestion, nausea, headaches. Side effects related to the hormone Progesterone - premenstrual syndrome-like symptoms, fluid retention, breast tenderness, backache, depression, mood swings, pelvic pain.
Who should not take HRT? ›Hormone replacement therapy and breast cancer risk
Because of this risk, doctors usually recommend that women with a history of breast cancer should not take types of HRT that affect the entire body (called systemic HRT). HRT has also been linked to cardiovascular risks, such as heart disease, stroke, and blood clots.
HRT does come with certain side effects, which tend to be most pronounced in the first few weeks and months of use. If you are unlucky, you may even find that HRT can make you feel worse before you feel better.
What are the pros and cons of hormone therapy? ›Hormone therapy can help ease symptoms of menopause. But it is associated with a lot of serious risks if used over the long term. Although the treatment lowers the risk of bone fractures, it increases the risk of cardiovascular disease (heart and blood vessel problems) and breast cancer.
Is it better not to go on HRT? ›
Stopping HRT
Most women stop taking it once their menopausal symptoms pass, which is usually after a few years. Women who take HRT for more than 1 year have a higher risk of breast cancer than women who never use HRT. The risk is linked to all types of HRT except vaginal oestrogen.
Recent findings show that although not completely risk-free, HRT remains the most effective solution for helping with symptoms of menopause and is also effective for the prevention of osteoporosis. It may also provide protection against heart disease.
Is it safer to take HRT or not? ›HRT can't be described as safe or unsafe. Its effects vary depending on the types of hormone used, the form in which it is given (pills, or patches and gels), and the timing of first use (around menopause, or later). The safety of HRT can also depend on other things, such as body mass index.
Which is the best HRT to go on? ›There are two ways of taking it: cyclical combined HRT is best if you have menopausal symptoms and still have periods. This involves having a gap between taking progestogen for a period of time. Continuous combined HRT is recommended if you are post-menopausal and have not had a period for a year.
Which estrogen has the least side effects? ›Estriol is the weakest of the three estrogen types. It's less likely to cause side effects like high blood pressure and blood clots than estradiol, the strongest estrogen.
What age should you not take HRT? ›Starting HRT after the age of 60 does not lower the risk of heart disease but it is not thought that it increases it either. Starting HRT over the age of 70 may have more risks than benefits. When to Stop HRT? There is no arbitrary age to stop HRT.
What is the safest HRT to use? ›So in summary, the safest types of HRT are the oestrogen applied through the skin as a patch, gel or spray with body identical micronised progesterone. Many women also benefit from testosterone, which may help if you're forgetful or having trouble concentrating at work.
What is the long term damage of HRT? ›For women who start HRT more than 10 or 20 years after menopause starts or when they're age 60 or older, the risks of HRT are greater than the benefits because HRT is linked to a higher risk of heart disease, stroke, blood clots, and dementia.
Is there a natural alternative to HRT? ›Several products are sold in health shops for treating menopausal symptoms, including herbal remedies such as evening primrose oil, black cohosh, angelica, ginseng and St John's wort.
What should you avoid on HRT? ›Avoid visible meat fat, butter, fried foods, cakes, pastries, packaged snack foods and biscuits.
Should a 65 year old woman take estrogen? ›
There is good news for older women age who are experiencing menopause symptoms like hot flashes and night sweats. You can safely get relief with hormone therapy (HT), according to the North American Menopause Society (NAMS).
How long does it take for your body to adjust to HRT? ›It can take your body time to get used to HRT. When you start HRT, you might have side effects. Examples are tender breasts, feeling sick (nausea) and leg cramps. These side effects usually disappear within 6 to 8 weeks.
Does vitamin D increase estrogen? ›Genes associated with follicle growth were not significantly altered by vitamin D3. However, it increases expression of genes involved in the estrogen-biosynthesis. Further, estrogen concentrations in porcine granulosa cell-cultured media increased in response to vitamin D3.
Can a 70 year old woman take HRT? ›There is no specific age cut-off for starting HRT.
What does the first week of HRT feel like? ›You might feel a bit sick or nauseous, or experience breast tenderness, bloating or headaches, particularly in the first few days. You can see a full list of side effects of the different hormones in HRT here. Bloating is a common side effect of HRT and can be a result of taking oestrogen or progestogen.
What happens in the first few weeks of HRT? ›Breast tenderness, bleeding, bloating and feeling low after starting HRT are not usually cause for clinical concern. If bleeding is heavy, persistent or prolonged, contains clots, or you are bleeding after sex, contact your GP to discuss this further.
Does HRT make you look younger? ›HRT is also known to help women maintain softer, smoother skin, resulting in a younger look. In addition to—and, often, as a result of—these physical changes, HRT often changes how you see yourself.
Is .5 mg of estrogen a lot? ›Low-dose estrogen is often considered to be 0.3mg or less of conjugated estrogen, 0.5mg or less of oral micronized estradiol, 2.5μg or less of ethinyl estradiol, or 25μg or less of transdermal estradiol.
What are the benefits of oestrogen only HRT? ›- Oestrogen reduces the severity and frequency of hot flushes by around 85%.
- Oestrogen improves vaginal dryness.
- By reducing menopausal symptoms, oestrogen may improve sleep and quality of life.
- Oestrogen reduces the risk of post-menopausal bone fracture, including hip fracture (1).
Symptoms of high estrogen in women
swelling and tenderness in your breasts. fibrocystic lumps in your breasts. decreased sex drive. irregular menstrual periods.
What are the side effects of taking estrogen after menopause? ›
Hormone therapy may cause side effects, such as bleeding, bloating, breast tenderness or enlargement, headaches, mood changes, and nausea.
What happens when you start taking estrogen HRT? ›The first changes you will probably notice are that your skin will become a bit drier and thinner. Your pores will become smaller and there will be less oil production. You may become more prone to bruising or cuts and in the first few weeks you'll notice that the odors of your sweat and urine will change.
How long can you take oestrogen only HRT? ›There's no limit on how long you can take HRT, but talk to a GP about how long they recommend you take the treatment. Most women stop taking it once their menopausal symptoms pass, which is usually after a few years.
What happens if you only take oestrogen without progesterone? ›Progesterone is used along with estrogen. Taking estrogen without progesterone increases your risk for cancer of the endometrium (the lining of the uterus). During your reproductive years, cells from your endometrium are shed during menstruation.
What does too much estrogen feel like? ›Summary. High estrogen levels can cause symptoms such as irregular or heavy periods, weight gain, fatigue, and fibroids in females. In males, they can cause breast tissue growth, erectile dysfunction, and infertility.
Is it better to have high or low estrogen? ›Estrogen helps protect the heart from disease, potentially by maintaining higher levels of good cholesterol, called high-density lipoprotein (HDL), in your blood. Lower estrogen levels, especially during menopause, can increase your risk of developing heart disease.
How do you know if HRT doesn't agree with you? ›Are you taking the right dose of HRT? If several months have passed and you are seeing no improvement in your menopause symptoms, it could be one of the signs that HRT is not working for you. You might need to increase your dose of HRT, specifically the oestrogen you are taking.
Can HRT do more harm than good? ›HRT can't be described as safe or unsafe. Its effects vary depending on the types of hormone used, the form in which it is given (pills, or patches and gels), and the timing of first use (around menopause, or later). The safety of HRT can also depend on other things, such as body mass index.
At what age should a woman stop taking hormone replacement? ›When to stop taking HRT. Most women are able to stop taking HRT after their menopausal symptoms finish, which is usually two to five years after they start (but in some cases this can be longer). Gradually decreasing your HRT dose is usually recommended, rather than stopping suddenly.