Question 1. 

I am in my late 40s and having some symptoms that may be related to menopause-do I need a blood test?

Answer: No! In the perimenopause blood tests can be normal as they fluctuate daily.Only younger women need hormone levels checked to confirm the diagnosis.Occasionally estradiol levels may be checked to monitor response to treatment.

Question 2. 

My mother had breast cancer in her 60s so does this mean I can't take HRT?
Answer: No.Most breast cancers are not genetic and the increased risk with HRT is very  small.

Question 3.

Does HRT cause weight gain?
Answer:There is no evidence HRT causes weight gain.Women tend to gain weight and have change in body shape with increased abdominal fat around the time of the menopause and HRT may actually help reduce this.

Question 4.

Does taking HRT just delay the symptoms and will I have to suffer eventually when I stop HRT?
Answer: No-HRT relieves the symptoms.The majority of women will be able to successfully discontinue treatment after a few years but some unlucky women will continue to have symptoms for many years and need long term if not lifelong HRT.There is no arbitrary time limit for HRT use.

Question 5.

I am perimenopausal do I still need contraception?
Answer:Yes! You need to use contraception for 2 years after last period if this happens below age 50 or for 1 year if last period is over age 50.The Mirena intrauterine system can be very useful as it minimises bleeding problems and provides the hormone progesterone so you can have oestrogen only HRT if needed.Other hormonal methods of contraception can be used with HRT.
HRT is not contraceptive!

Question 6.

I am having bleeding problems on HRT should I be concerned?
If you have been on ‘no bleed HRT for less than 6 months bleeding is very common and usually settles.If you have been bleed free for more than 6 months on HRT and start bleeding please see your GP for an urgent referral for gynaecological assessment or book an appointment with one of my gynaecology colleagues in Kingsbridge.

Question 7.

Can you prescribe bio-identical HRT?
Bio-identical HRT is unregulated,unlicensed and not necessarily better or safer than conventional prescribable HRT .However body identical HRT is commonly used and available on NHS prescription from your GP.It is usually in the form of an oestrogen patch or gel with separate Utrogestan, a natural progesterone.
Please see this fact sheet for more information