Menopause (HRT) Initiation Service (Consultation + 3 Months Supply)

No – treatments aren’t selected directly before the consultation. Instead, you’ll be asked about your preferences during the consultation process, and a clinician will recommend the most appropriate treatment based on your needs and suitability.

Yes. It’s very common to adjust treatment after starting HRT. Different brands, doses and delivery methods (such as patches, tablets or gels) can suit people differently. At your 3-month review, your clinician will check how you’re getting on, whether your symptoms have improved and whether you’re experiencing any side-effects.

If the current brand isn’t working well for you, it can usually be changed to something more suitable.

There’s no fixed time limit for HRT. You can continue treatment for as long as the benefits outweigh any risks. Many people stay on HRT for several years, and some continue long-term if it effectively manages symptoms and improves quality of life.

After three months, you’ll have a review to discuss how the treatment is working for you. This is the point where symptoms, improvements, and any side-effects are assessed. Your clinician may adjust the dose, change the type of HRT or switch brand if needed. These ongoing check-ins help ensure your HRT remains beneficial and safe and that any new concerns or changes to your health are properly managed. You can be reviewed earlier if issues arise before the assessment.

HRT is considered safe and effective for most women, especially if started under the age of 60 or within 10 years of menopause. Like any treatment, it does carry some risks, but these are usually small and depend on the type of HRT you use, your age, your general health, and how long you take it for.

Some types of HRT can slightly increase the risk of certain cancers. Combined HRT (oestrogen with progestogen) may slightly increase the risk of breast cancer if used for several years, although the risk falls after stopping treatment. Taking oestrogen on its own can increase the risk of cancer of the womb lining if you still have a uterus, which is why progesterone is added to protect the womb. There may also be a very small increase in ovarian cancer risk, although this is rare.

There is also a small increased risk of blood clots and stroke with tablet forms of HRT, particularly in older women or those with other risk factors such as smoking or obesity. HRT given through the skin, such as patches or gel, carries a much lower risk of blood clots and is often recommended for women with higher risk factors.

For many women, the benefits of HRT — including relief from symptoms, improved sleep and mood, and protection for bone health — outweigh the risks. Your clinician review your medical history and choose the safest and most suitable option for you.

Some women choose to take supplements or herbal remedies alongside HRT, but these should be used with caution. Many are not well regulated, and evidence for how well they work is limited. “Natural” does not always mean safe, and some supplements can interact with medicines or may not be suitable for women with hormone-sensitive conditions.

You should always discuss any supplements with your clinician before starting them, especially if you take other medications or have a history of breast cancer, blood clots, or liver disease.

Lifestyle measures such as regular exercise, good sleep, a balanced diet, and adequate calcium and vitamin D are recommended for overall menopause and bone health. Evidence-based HRT remains the most effective treatment for menopausal symptoms for most women.

Many people begin to notice improvements in symptoms – such as hot flushes, night sweats or mood changes – within a few weeks of starting HRT. For others, it may take up to 3 months to feel the full benefits. Your body needs time to adjust, and it’s normal to experience mild, settling side-effects at first. Because of this adjustment period, most clinicians recommend staying on the initial treatment for at least 3 months unless the side-effects are severe.

If your symptoms haven’t improved by your first review, your treatment can be reassessed and tailored to suit you better.

Yes – if symptoms are still troubling you by your 3-month review, or sooner if needed, your treatment can be adjusted. This might mean changing the type of HRT, altering the dose, or trying a different route such as patches or gel.

You don’t need to wait until your three-month review if you’re worried. If you experience troublesome side-effects, unexpected symptoms or anything that feels concerning, contact your clinician or pharmacy team for advice. They can help determine whether what you’re experiencing is normal in the early stages or whether your treatment needs adjusting.