Common Questions About Continuous Combined Hrt

NHS medicines information on common questions about continuous combined HRT.

How does continuous combined HRT work?

As you approach the menopause, levels of the sex hormones oestrogen and progesterone fall, which causes symptoms such as hot flushes, night sweats, mood swings and vaginal dryness.

Continuous combined HRT works by replacing these hormones, which helps to improve menopause symptoms.

When will I feel better?

It can take up to 3 months for hormone replacement therapy (HRT) to work fully to improve your symptoms.

There are different types of HRT, and it can take time to find the type and dose that works for you.

If you do not feel better after 3 months, speak to your doctor. They may suggest changing your dose, or switching to a different type of HRT.

Are there any long-term side effects?

It's best to only take HRT at the lowest dose that works for you, and only for as long as you need it to control your menopause symptoms.

This is because HRT can slightly increase the risk of breast cancer and blood clots. The risk is small, but it increases the longer you take HRT.

Usually, the risk is outweighed by the benefits of HRT, such as improving menopause symptoms, quality of life and preventing osteoporosis. But this depends on your age, symptoms and health. Speak to your doctor, who can help you decide.

Find out more about the benefits and risks of HRT

How does it compare with other types of HRT?

There are several different types of HRT. They all work equally well to replace the hormones that fall during and after the menopause.

No one type of HRT is suitable for everyone. You may need to try different types to find what works best for you.

Continuous combined HRT is for when you have not had a period for at least 1 year. It's not suitable if you're still having periods (perimenopause), or within 12 months of your last period, because it may cause irregular bleeding. In these cases you can take sequential combined HRT instead.

Combined HRT contains an oestrogen and a progestogen to protect your womb. If you've had a hysterectomy to remove your womb, you'll be advised to take oestrogen-only HRT.

Your doctor can help you decide on the type of HRT that's best for you.

Find out more about types of HRT

How does it compare with alternatives to HRT?

Hormone replacement therapy (HRT) such as continuous combined HRT is usually the most effective treatment for menopause symptoms.

If you cannot take HRT, or prefer not to take it, your doctor may be able to recommend other medicines or lifestyle changes to help with your symptoms.

Medicines such as clonidine and some antidepressants (such as fluoxetine or sertraline) are sometimes used as an alternative to HRT to help with symptoms such as hot flushes, night sweats and mood swings.

Find out more about alternatives to HRT

What will happen if I stop taking it?

If you stop taking HRT your menopause symptoms might come back.

Talk to your doctor if you're thinking of stopping. They will help you decide what's best for you. They may suggest that you reduce your dose gradually, to help stop symptoms coming back.

If you're having problems with side effects, your doctor might suggest changing your dose, or switching to another type of HRT.

Can I switch to a different brand?

There are different brands and types of continuous combined HRT. A pharmacist or doctor can advise on which type would be suitable. It will depend on whether you prefer to take tablets, capsules or patches and what dose you need.

If the brand or type of HRT that you've been using is not available because of supply shortages, or is not helping your symptoms, or if you have problems with side effects, a doctor or pharmacist can advise about switching to a different type.

Can I get continuous combined HRT for free?

You'll need to pay for your hormone replacement therapy (HRT) prescriptions unless you're eligible for free prescriptions.

However, you can reduce the cost by getting an HRT pre-payment certificate (PPC). This means you can pay a small fee that will cover all your HRT prescriptions for a year.

Find out how to save money with a prescription prepayment certificate.

Will I gain or lose weight?

There is no good evidence that continuous combined HRT makes you put on weight.

However, it's common to gain weight around the time of the menopause. Eating a balanced diet and exercising regularly will help you keep to a healthy weight.

Will it affect my contraception?

Continuous combined HRT is not a contraceptive.

It's still possible to get pregnant while taking HRT, so you'll need to use contraception until 2 years after your last period if you're under 50, or for 1 year if you're over 50.

You'll need to use a non-hormonal method of contraception such as condoms or a diaphragm, or other options which you can speak to your doctor about.

Can I drive or ride a bike?

Continuous combined HRT does not affect your ability to drive or ride a bike.

Can I drink alcohol while taking continuous combined HRT?

You can drink alcohol while taking HRT but it may be helpful to cut down on caffeine and alcohol during the menopause to reduce symptoms of flushing, and improve your sleep.

Is there any food or drink I need to avoid?

You can eat and drink normally while taking continuous combined HRT.

Try to have a healthy diet, as this can help with menopause symptoms and keep you well.

Cutting down on alcohol and caffeine may help reduce hot flushes.

Can lifestyle changes help menopause symptoms?

The following lifestyle changes can sometimes help with menopause symptoms:

• Take regular exercise. This helps with bone health and can reduce hot flushes and improve your sleep. It may also help improve your general mood, reduce stress and help you keep to a healthy weight.
• Cut down on caffeine and alcohol. This may help reduce hot flushes and improve your sleep.
• Quit smoking. This can help reduce hot flushes and reduce your risk of developing other health problems such as cancer, heart disease and stroke.

Find out more about lifestyle changes for menopause symptoms

If you want to find out more about this particular topic you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.