Menopause and HRT: What You Need to Know

Menopause is not just a phase; it’s a fundamental change that every biological woman will experience. Understanding it, and knowing how to manage it, is vital” - Dr Sibel Peck, GP and Founder of Private GP Services, and member of the British Menopause Society.

Understanding Menopause

Menopause is defined as one year since a woman’s last menstrual period. The transition leading up to it is known as perimenopause, which on average lasts around eight years.

In the UK, the average age of menopause is 50–51, while the average life expectancy for women is 82. That means almost half of a woman’s life may be spent in the menopausal state. During this time, women are often balancing careers, children, and caring for ageing parents – all the while managing symptoms that can vary widely.

Common Symptoms

Every woman’s experience is different. Some may have few or no symptoms, while others experience a range of challenges, including:

  • Menstrual changes – heavier, lighter, or less frequent periods
  • Mental health – anxiety, low mood, fatigue, tearfulness, brain fog, headaches
  • Vasomotor symptoms – hot flushes, night sweats, palpitations, itchy or red skin, rosacea, dizziness
  • Migraines - may worsen with hormonal changes in perimenopause, though some improve after periods stop
  • Other issues – weight gain, dry hair, dry eyes, vaginal dryness, bloating, recurrent cystitis, low libido, joint aches and pains

Diagnosis is primarily based on recognising symptoms. Blood tests are rarely required, although in menopause your GP may check hormone levels such as FSH, oestradiol, and testosterone.

Hormone Replacement Therapy (HRT)

The most effective treatment for menopause is replacing the hormones that the ovaries stop producing. This is known as hormone replacement therapy (HRT).

Types of HRT

There are a variety of forms available, including:

  • Gels
  • Skin patches
  • Tablets
  • Other specialist preparations

The right option depends on your individual health, lifestyle, and preferences. A consultation with a GP is essential to discuss the safest and most effective treatment plan, along with regular follow-up.

Benefits of HRT

Studies show that starting HRT early and continuing long-term can offer major health benefits, including:

  • Reduced risk of osteoporosis and fractures
  • Lower risk of heart disease and dementia
  • Potential protective effects against bowel cancer, fibromyalgia, and rheumatoid arthritis
  • Improved sleep, mood, and quality of life

Common Concerns

Many myths surround HRT. Dr Peck addresses some of the most common misconceptions:

  • “I’m over the menopause now.” – Menopause is not something you ‘get over’. Symptoms may change over time, but menopause persists for life.
  • “I’ve been offered antidepressants instead.” – If symptoms are hormonal, HRT is usually the most effective treatment.
  • “I can’t take HRT because of migraines or blood clots.” – Transdermal options (such as patches or gels) can still be safe.
  • I worry about the risk of breast cancer.” – Evidence shows that transdermal and body-identical HRT carry little to no increased risk of breast cancer. Lifestyle factors such as smoking, being overweight, or drinking more than two units of alcohol a day increase risk far more significantly than HRT does. or a detailed breakdown of breast cancer risk factors and evidence-based research, see the Women’s Health Concern guide to Understanding Risks of Breast Cancer (PDF)
  • “I’ve had breast cancer, so I can’t have anything.” – Local vaginal oestrogen is not classed as HRT and may be appropriate to treat dryness and discomfort.

Private GP Support

Managing menopause is not one-size-fits-all. A private GP can provide longer consultations, personalised care, and quicker access to treatment options, ensuring you feel supported at every stage.

Further Resources

For more detailed information, visit: