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HRT and alternatives

Information for women, their partners and families about hormone replacement therapy (HRT) and the alternatives for treatment of menopausal symptoms

What is HRT?

Hormone replacement therapy, or HRT, is widely used to treat menopausal symptoms.

As you approach the menopause, your ovaries produce less and less of the hormone estrogen. Estrogen controls a woman’s reproductive cycle as well as controlling other functions, including bone density, skin temperature and keeping the vagina moist. This reduction in estrogen causes most symptoms associated with the menopause, including:

  • Hot flushes
  • Night sweats
  • Vaginal dryness
  • Loss of sex drive
  • Stress incontinence (leaking urine when you cough or sneeze)
  • Bone thinning (which can lead to osteoporosis and fractures)

The aim of HRT, as its name suggests, is to replace or ‘top up’ the body’s natural supply of estrogen. Estrogen also stimulates the lining of the womb, so you will also need to take another hormone, progestogen, at the same time to protect your womb lining.

If you have had a hysterectomy, you may not need progestogen and may be prescribed estrogen-only HRT. However, depending on the reason for your hysterectomy and the type of hysterectomy you have had, you may be advised to use estrogen and progestogen combined HRT.

You can read about various treatment options for symptoms of the menopause, including lifestyle changes, prescribed and non-prescribed treatments, in the RCOG patient information Treatment for symptoms of the menopause.

Find out more about HRT

The following links provide information and advice about HRT:

Alternatives to HRT

Why would I choose an alternative to HRT?

Not every woman chooses HRT or can have HRT to help their symptoms of the menopause. For you, this may be because:

  • You want an alternative treatment that works especially well for one particular symptom
  • You have concerns about the safety and side effects of HRT
  • You would prefer alternative treatments to help alleviate symptoms of the menopause

What are the alternatives to HRT?

The alternatives to HRT can be broadly classified as:

  • Herbal medicine - a practice based on the use of plants or plant extracts to relieve symptoms, e.g. evening primrose oil or St John’s Wort
  • Alternative medicine - a range of therapies used instead of conventional medicine, such as acupressure, acupuncture and homeopathy
  • Complementary therapy - interventions that tend to be used alongside conventional medicine, e.g. aromatherapy with HRT
  • Non-hormonal medical treatments - treatments prescribed by your doctor, such as antidepressants

Find out more about alternatives to HRT

The following links provide information about the alternatives to HRT:

Making a choice about your treatment

There will be choices to make about the type of treatment you wish to receive. You will probably have a lot of questions and may wish to discuss your options with family and friends. To begin with, try to get answers to three key questions:

  • What are my options?
  • What are the pros and cons of each option for me?
  • How do I get support to help me make a decision that is right for me?

For more information about working with your healthcare professional to make the right choice for you, please visit the NHS Shared Decision Making website.

About the links on this page

Some of the information this page links to  is not produced by the RCOG. Our policy on publishing links to third-party sites outlines how we decide which sites to link to, and our terms and conditions include a disclaimer about the RCOG’s responsibility for information on linked sites.


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