Is HRT safe? Discussing HRT myths, natural HRT and my own menopause journey

I have written about HRT several times over the last 10 years and they are always some of my most-read blog posts.  It seems that women are still looking for clear, honest, good quality information about perimenopause and menopause. We are still trying to understand what is happening to our bodies and trying to work out whether the symptoms we are living with are due to a busy life, stress, ageing, anxiety or whether they might actually be connected to our depleting hormones.  

And then when we have worked it out and want to discuss our options - maybe we think it is time to try HRT - but HRT still feels confusing!  

One friend says it changed her life. Another says it is dangerous. Someone else says she doesn't need HRT because she does not have symptoms. Then an unqualified voice online shares an old headline about cancer, strokes or blood clots and suddenly it all feels frightening again.

Recently I saw someone on Instagram say that HRT caused her to have a stroke. There was no context, no explanation and no balance around the fact that, for many women, the benefits of HRT can outweigh the risks. There was no information about the difference between older synthetic HRT and the new transdermal HRT menopause specialists recommend today. There was no mention of dose, age, health history, personal risk factors or which hormones were being used.  Without context, I think posts like that can be really unhelpful and frightening.

A lot of the fear around HRT still comes from older headlines, older synthetic hormones, older prescribing habits and studies that do not always reflect the way many menopause specialists prescribe today.  Menopause training and experience can still vary hugely too. Some women get excellent support from their GP, while others are still dismissed, rushed or offered antidepressants without a proper menopause conversation.

This blog is not medical advice. I am not a doctor and I would never tell another woman what she should take. But I do have my own experience and I have learned, sometimes the hard and expensive way, that not all HRT advice is equal.

What I want to do here is share what I wish I had understood earlier about HRT, natural hormones, progesterone intolerance and why it is never too late to ask for proper help. 
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Women deserve better than fear, confusion and half-truths.  We deserve clear information, proper support and the confidence to explore what is right for our own bodies.  I hope in this post I can clear up some misinformation and point you in the right direction for finding the support you need.

It's a long one, but it needs to be!  Make a cup of tea and get comfortable!
Full disclaimer and references are provided.

I have done so much research and reading on menopause and HRT over the last 10 years!

My own HRT journey started with confusion

Way back in my mid-40s, I went to see my GP with a few early symptoms, although at the time I had no idea what perimenopause really was, it wasn't a term in common use then.

I thought I was too young to be menopausal. I thought menopause was simply that your periods stopping completely and you had a few hot flushes and to me that was a long way in the future. I also did not have my own mum’s experience to guide me because she had a full hysterectomy at 40 due to severe endometriosis.

My GP sent me for a scan to see what was happening with my ovaries and, because there was still activity on one side, I was told it was not menopause. I was then prescribed antidepressants.

Looking back, I can see how easily this happens. Perimenopause can start years before periods stop and symptoms can be very up and down. But at the time, I did not know what questions to ask. I simply knew I did not feel right but I trusted the doctor.

Time passed and I still felt unsettled, so I made an appointment to see a private GP who specialised in HRT, or so I thought.  I was still cautious about taking HRT due to all the negativity and so I was relieved to be seeing someone who seemed to understand hormones and menopause. But looking back, I now know I wasted a lot of time and money because I was prescribed compounded bioidentical HRT rather than regulated body-identical HRT.
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And this is where it all gets more confusing.

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A quick note on the different types of HRT ...

When I talk about HRT on my blog, I am talking about the newer type of HRT good menopause specialists now prescribe: regulated body-identical HRT, usually transdermal oestrogen, which means oestrogen delivered through the skin as a gel, patch or spray.

Body-identical simply means the hormone has the same structure as the hormone our body naturally makes. So estradiol is the body-identical form of oestrogen prescribed now. And micronised progesterone, such as Utrogestan, is a body-identical form of progesterone.  

This is different from the older-style synthetic hormones, which are chemically made to act like hormones but are not identical to our own hormones. A lot of the fear around HRT comes from older studies and headlines that involved different types of HRT from the ones women are prescribed now.

There is another important distinction too. Regulated body-identical HRT is not the same as compounded bioidentical HRT.

Regulated body-identical HRT is prescribed by your GP or menopause specialist and is licensed, tested and quality controlled. Compounded bioidentical HRT is usually made up privately by a compounding pharmacy in bespoke doses. It can sound very appealing, especially when it is marketed as natural or personalised, but it is not regulated in the same way.  Some private clinics still offer this, often using language that sounds very appealing, but I would be cautious and always ask whether the treatment is regulated, licensed and recommended by current menopause guidance.​

The British Menopause Society is very clear on this. It says compounded bioidentical HRT is not recommended by national or international guidance because it is not evidence-based for effectiveness and safety. It also says regulated body-identical HRT options are available and, wherever possible, regulated products should be prescribed.

So this blog is not about unregulated compounded hormones.
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It is about regulated, evidence-based HRT, especially transdermal oestrogen, and why I believe women deserve clear, up-to-date information rather than the old fear-based headlines that keep getting repeated!

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I went back to my GP and was referred to the menopause specialist within our GP practice.  Which was the best decision!
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But I will come back to my own story later in this blog, because first I want to look at some of the common HRT myths that still frighten so many women.

Why the delivery method of oestrogen is important

One of the most important things I have learned is that the way you take HRT is a priority.

Remember regulated body-identical oestrogen, called estradiol, has the same structure as the oestrogen our bodies naturally make.

For many women, transdermal oestrogen is the preferred first option. Transdermal simply means oestrogen through the skin as a gel, patch or spray. This is the route many menopause specialists recommend because it avoids the first-pass effect through the liver and has a different risk profile from taking oestrogen by mouth.

But transdermal is not the only way body-identical estradiol can be given. I now have an oestrogen implant, which is placed under the skin by my private menopause specialist. It is not the usual first option and it can be difficult to access on the NHS, but for me it has worked well because I was not absorbing enough oestrogen from patches or gel.

So this blog is all about regulated, evidence-based HRT using body-identical hormones, most commonly transdermal oestrogen, and in my own case, an oestrogen implant.

This is where some of the old fear around HRT becomes unhelpful and confusing.

When someone says 'HRT causes strokes' they are often putting all types of HRT into one big scary box. But regulated body-identical oestrogen is not the same as older synthetic HRT. It is also not the same as taking oestrogen in tablet form.
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For example, NICE says the risk of venous thromboembolism, which means blood clots in the veins, is not increased with transdermal HRT but is increased with oral HRT.  NICE also says stroke risk is unlikely to increase with combined HRT that includes transdermal oestrogen, while stroke risk increases with combined HRT containing oral oestrogen, particularly with higher doses, longer use and older age at starting.

The important message is that route, age, dose, personal risk factors and the type of hormones being used all matter.

This does not mean HRT is risk-free, no medical treatment is. But it does mean women deserve the whole picture, not just a frightening caption on social media.

Finally feeling like me again after deciding to get the HRT implant

Common HRT myths that still worry women

I wanted to include this section because these are the things I often hear from women and I understand.

Most of us grew up hearing negative things about HRT. Many of us remember the headlines (about the big breast cancer scare). And when you are already tired, anxious, not sleeping or feeling unlike yourself, the last thing you want is more fear. 

My mum stopped HRT because of the scare stories in the news. Looking back, that feels especially sad because she had already had a full hysterectomy and was taking oestrogen-only HRT, so her risk profile was different from a woman taking combined HRT with a progestogen.
Would continuing oestrogen have made any difference to her later dementia diagnosis? I will never know and I would not want to overstate it. But it is one of the reasons I feel so strongly that women deserve proper conversations about hormones, brain health and long-term wellbeing, rather than decisions based on fear.
So here I am sharing a few of the common myths, but with a bit more balance and context.

Myth 1: HRT causes strokes

The more accurate statement is: some types of HRT may increase stroke risk, but regulated body-identical oestrogen given through the skin does not appear to carry the same risk as taking oestrogen by mouth.

NICE says stroke risk is unlikely to increase with combined HRT that includes transdermal oestrogen. It also says stroke risk increases with combined HRT containing oral oestrogen, and that this increase is greater with higher doses, longer use and older age when starting HRT. NICE also says stroke risk is unlikely to increase with transdermal oestrogen-only HRT.

So when I saw that post on Instagram where someone blamed her stroke on HRT, my response would be that is far too simple and an irresponsible statement without context:

It depends what type of HRT we are talking about.
It depends how it is taken.
It depends on your age, your health history, your dose and your own personal risk factors.
That does not mean we ignore the risk, it just means we must understand it properly.

Myth 2: HRT causes blood clots

NICE says the risk of venous thromboembolism, which means blood clots in the veins, is not increased with transdermal HRT. NICE also says VTE risk is increased with oral HRT and is greater with oral than transdermal HRT.

This is why menopause specialists now choose transdermal oestrogen, such as gel, patch or spray, particularly for women who may already have a higher clot risk.

A frightening headline about blood clots is not the same as a proper conversation about your own risk, your own health and the safest route for you.

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Myth 3: HRT always causes breast cancer

​This is probably the biggest fear that still sits at the heart of the HRT conversation for many women.
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And yes some types of HRT can increase breast cancer risk but let's now clarify what combined HRT actually means.

If you have had a hysterectomy, you may be able to take oestrogen-only HRT. NICE says there is very little or no increase in breast cancer risk with oestrogen-only HRT and little or no increase in the risk of breast cancer mortality.

But if you still have your womb, you usually need progesterone or a progestogen alongside oestrogen. This is called combined HRT and it is needed to protect the womb lining. Oestrogen on its own (unopposed oestrogen) can thicken the womb lining and increase the risk of endometrial cancer.

So when we talk about breast cancer risk and HRT, we need to be clear what type of HRT we mean.

NICE says breast cancer risk increases with combined HRT and that the increase rises with duration of use. It also says breast cancer risk varies depending on a person’s own modifiable and non-modifiable risk factors, but ...

Even within combined HRT, there are different types ... yes it does need to be understood properly!

Some progesterone options are body-identical, such as micronised progesterone, often prescribed as Utrogestan (oral tablet or vaginal pessary). Some are synthetic progestogens. Some women use a Mirena coil, which releases levonorgestrel directly into the womb and can be used as the progesterone part of HRT.

The British Menopause Society says evidence from large observational studies and case-controlled studies suggests micronised progesterone and dydrogesterone are associated with a lower risk of breast cancer compared with oral progestogens (notice the subtle spelling difference). NICE is more cautious and says there is currently insufficient evidence to establish whether the increase in breast cancer risk is different with preparations containing micronised progesterone or dydrogesterone compared with other progestogens.

So to say there is no risk, is also too simple.  But neither can we say 'HRT causes breast cancer' because the type of HRT is important as well as a woman's individual risk.  So instead consider:

Whether you need oestrogen-only or combined HRT.
The type of progesterone or progestogen that suits you best.
Your age, family history, weight, alcohol intake, breast density, previous breast problems and personal risk factors..
And don't forget that quality of life is important too!

Have a conversation with your doctor (preferably a menopause specialist) about absolute risk, personal risk, the type of HRT being used, how long you use it for and whether the benefits continue to outweigh the risks for you.

I had an interesting example of this recently after being recalled following a routine mammogram. Thankfully, everything was fine, but during the appointment the breast doctor said to me, 'you can't stay on HRT forever'.

I understand where that caution comes from, a breast specialist is looking at HRT through the lens of breast health and breast cancer risk.

But my own menopause specialist is happy for me to stay on HRT for as long as I want to, provided I am reviewed properly and the benefits continue to outweigh the risks for me and provided I continue to get my mammograms.

So we all need to have an informed, individual conversation that looks at the whole woman, not just one possible risk.

The British Journal of General Practice says "Since the Women’s Health Initiative (WHI) study was published in 2002, HRT has caused significant concern and worry among women and also healthcare professionals. Many women are still being denied HRT by their doctors, which often results in them suffering with numerous symptoms for years, and which can have a very negative effect on the quality of their lives."

May I recommend an excellent book if you'd like to understand more?  Oestrogen Matters by Avril Bluming and Carol Tavris was written to enlighten its readers with detailed information about the history regarding the WHI study and also presents in detail numerous studies supporting the use of HRT. Neither of the authors has a personal vested interest in HRT and their passion to impart evidence-based information is very evident throughout this book.

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Myth 4: You can only take HRT for five years

There is not a universal five-year stop alert!  NICE says that when someone chooses to take HRT, the possible duration should be discussed at the outset and the benefits and risks should be discussed at every review. It also says symptoms may return when HRT is stopped and restarting treatment can be discussed if needed.

For some women, short-term use may be right, for others, longer-term use may be appropriate.

The important thing is regular reviews, individualised care and a conversation about whether the benefits still outweigh the risks for you.

The other thing I think we forget is that our hormones do not suddenly come back after five years, there is no magic date when our bodies decide they can manage without oestrogen again. Historically, women were less likely to spend decades living beyond menopause, but now many of us can expect to live for 30, 40 or even more years after our periods stop.

I do not want to just get through midlife. I want to feel well, protect my long-term health where I can and have a good quality of life as I age. So yes, if I can stay on HRT safely, with proper reviews and specialist support, that is absolutely my plan.
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Myth 5: It is too late to start HRT after 60

Starting HRT after 60 is not the same conversation as starting it in your early 50s.  The risks and benefits may be different and it needs to be carefully considered.

NICE says stroke risk from oral oestrogen-only HRT is greater if HRT is started after 60, but it also says stroke risk is unlikely to increase with transdermal oestrogen-only HRT.

So more importantly, it is never too late to ask for help.

If you are still struggling with symptoms, sleep, mood, vaginal dryness, bladder symptoms, joint aches, bone health worries or simply feeling unlike yourself, you deserve a proper conversation with someone who understands menopause.

That conversation may be more cautious after 60. It may involve a lower dose and, where appropriate, transdermal oestrogen rather than other routes. It may involve looking carefully at your personal health history. But it should still be a conversation, at 60, 70, 80 and beyond.​

Myth 6: HRT is only for hot flushes

Hot flushes and night sweats are the symptoms everyone seems to know about (and joke about) but menopause can affect so much more than body temperature.

NICE lists menopause-associated symptoms as including hot flushes and sweats, vaginal dryness, mood effects such as depressive symptoms, joint and muscle pain and sexual difficulties. It also recommends offering HRT to people with vasomotor symptoms, which means symptoms such as hot flushes and night sweats.

But the benefits of HRT are not just about symptom control.

Oestrogen has important roles throughout the body. When our oestrogen declines, it can affect bones, heart and blood vessels, joints, mood, sleep, vaginal and bladder tissues and a lot more.

Bone health is one of the clearest examples. NICE says fragility fracture risk is decreased while taking HRT although it decreases once treatment stops.

Fragility fractures and osteoporosis can have a huge impact on confidence, independence and long-term health.

Heart health is more nuanced. HRT is not prescribed simply to prevent heart disease, and NICE says it should not be offered for primary or secondary prevention of cardiovascular disease. But NICE also says coronary heart disease risk and cardiovascular disease mortality do not increase with combined HRT, and coronary heart disease risk does not increase with oestrogen-only HRT.

Why HRT is part of a bigger health conversation

So much of the conversation around HRT is fear-based or confusing, but we do not always talk enough about the possible long-term health benefits. This is why I feel frustrated when HRT is discussed only as a treatment for hot flushes. Even if a woman does not have obvious symptoms, it may still be worth having a conversation about hormones, bones, heart health, vaginal health and quality of life. Living for years with low oestrogen can have an impact on the body, and I think women deserve to understand that too.
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Oestrogen has important roles throughout the body. When our levels fall, it can affect bones, heart and blood vessels, joints, sleep, mood, vaginal and bladder tissues and more.
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For many women, regulated body-identical HRT should be part of a wider discussion about long-term health, quality of life, bones, heart health and feeling well as we age.

And for me I see the benefits of taking HRT every day.

There are the obvious things, like my skin, hair and nails all look and feel better. There are the emotional benefits too, my mood is more even, I sleep better and I feel more like myself.

But it is also about the less visible, long-term benefits. I want to do what I can to support my bones, my heart, my brain and my overall health as I age.

Having watched my mum come off oestrogen-only HRT and later decline into dementia, and having lost my maternal grandmother far too early to heart failure,  I cannot help but feel aware of my own future health and how I can do my best to live a long, healthy and happy life.
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Of course, HRT is not a guarantee against illness, nothing is. But with the support of my private menopause specialist and my Women's Health GP, and with regular reviews, I feel reassured that I am making an informed choice that supports both how I feel now and how I hope to age.

Transdermal oestrogen gel is a popular choice for women but not everyone absorbs it well

Why HRT still has to be individual

One of the biggest things I have learned is that HRT is not one-size-fits-all.  Please don't give up if after 3 months you don't feel any better.

Even when you are using regulated body-identical HRT, the route, dose and balance still needs to be personalised. What works beautifully for one woman may not work for another.  And sometimes it is not that HRT has failed, it is that the type, dose or absorption is not right for you.  It is a continual journey of tweaks.

After moving away from compounded bioidentical HRT, I started again through my GP practice and was referred to the menopause specialist there. 

I tried a patch first.  A lot of women get on really well with patches and it is often the first stop in HRT prescribing. They are simple, steady and discreet. Some patches are oestrogen-only and some are combined patches, which means they include a progestogen too, so it is always important to know exactly what you are taking and whether you still need separate progesterone.

But for me, the patch did not work well enough and my body did not seem to absorb enough oestrogen and my symptoms remained.

I then moved to gel, which worked really well for a while. But as my own oestrogen continued to decline, and I needed more support, my symptoms started creeping back in and, when I had blood tests, we could see that my oestrogen levels were not high enough.

All women should know that sometimes it is not that HRT 'doesn’t work for me' it is more often that the dose is not right, or the route is not right, you might not be absorbing properly or you might not yet have the right balance of oestrogen and progesterone.

For a while I was using five pumps of gel, which is above the usual licensed dose of four pumps.  And many doctors won't prescribe any more than four pumps but this is where individualised care is so important and not unusual in medicine, it simply means a doctor is prescribing according to your symptoms, your response and your individual situation.

I was not absorbing enough anyway, so the higher dose was not giving me too much. We were trying to get me to where I needed to be.

This is why a good menopause specialist is important. They will not just hand you a prescription and leave you to get on with it. They will look at your symptoms, side effects, medical history and, in more complex cases, may use blood tests to help understand what is happening.

For most women over 45 with typical symptoms, blood tests are not usually needed to diagnose perimenopause or menopause. But in my case, I was already on HRT and still symptomatic, so blood tests helped show that my oestrogen levels were still low.

Once I understood I was not absorbing enough oestrogen from the patch or gel, I could look at other options.

Progesterone was a big part of my struggle

If you still have a womb and you take oestrogen, you need progesterone or a progestogen to protect the womb lining.  Unopposed oestrogen can build up the lining of the womb and, without proper protection, that can increase the risk of endometrial cancer. 

But for a long time, progesterone was the difficult bit for me.

I was originally taking Utrogestan, which is micronised progesterone and is often very well tolerated. Lots of women feel calmer on it and sleep better. Progesterone can be supportive for sleep and anxiety for some women.

But if you are progesterone intolerant, it can feel very different.

Some women experience low mood, anxiety, irritability, tearfulness or a heavy, flat feeling that feels very hard to push through. That was my experience when the balance was not right.  I tried lots of combinations and doses, working with my specialist, and certainly a vaginal pessary is better than an oral tablet.  But I still struggled.

Looking back, I think part of the problem was that my oestrogen was still too low. I was not absorbing enough from the patch or gel, but I was still having to take progesterone. So the whole balance was wrong for me.

In the end I came off the progesterone while we got my oestrogen levels right.  This is not a recommended option and can only be done with strict guidance from a specialist.  In my case I'd had a vaginal ablation (Novasure) many years ago so had very little womb lining left anyway, so while we were working it all out, I had regular pelvic scans to monitor any changes (there were none).

When I eventually settled down on the HRT implant, I started taking dydrogesterone as my progesterone option and, for me, it has been much better.

Dydrogesterone is a progestogen, but it is structurally very close to natural progesterone. It is not the same as Utrogestan, which is micronised progesterone and is body-identical, but it is considered one of the more selective progesterone options and many women who struggle with progesterone tolerate it better.

My private specialist explained that dydrogesterone was a good option for me because it is very close to Utrogestan in the way it behaves, but for some women it can be easier to tolerate.

It is also positive from a risk point of view. The British Menopause Society says evidence from large observational studies suggests micronised progesterone and dydrogesterone are associated with a lower risk of breast cancer compared with some other oral progestogens. NICE is more cautious and says there is not enough evidence yet to say clearly whether the breast cancer risk differs between different types of progestogen.

I do think it is important for women to know that progesterone has more than one option. If you struggle with one type, it may be worth asking what else you can try and asking if your oestrogen level is high enough.
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We need options, one woman’s perfect HRT regime can be another woman’s nightmare.

Make sure you do your own research and go to your GP armed with the information you need to be heard!

Why I moved to an oestrogen implant

Once we understood that I was not absorbing enough oestrogen from patches or gel, I needed to look at another option.  That is when, with the support of my private menopause specialist, I moved to an oestrogen implant and that was the turning point.

An oestrogen implant is placed under the skin and releases estradiol gradually. It is not the usual first option for HRT and it can be difficult to access on the NHS. I pay privately for mine and I know I am fortunate to be able to do that, but for me it has been worth every penny.

Because I was not absorbing enough from gel or patches, the implant has given me a more reliable level of oestrogen. My symptoms improved. I felt more settled. My mood felt more even. I tolerated my progesterone better. And, most importantly, I felt much more like myself again.

I do not say that because I think every woman needs an implant. She absolutely does not.  Many women do brilliantly on gel, patches or spray. Some women need a low dose. Some need a higher dose. Some need a different progesterone. Some need vaginal oestrogen as well. Some may not want or need HRT at all.

But my experience shows why individualised care is so. important.

If your symptoms are still there, it does not always mean HRT has failed. It might mean your dose is not right. It might mean your route is not right. It might mean you are not absorbing properly. It might mean the progesterone part needs reviewing.
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And it might mean you need a practitioner who really understands menopause and is willing to look at the whole picture.

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Vaginal oestrogen deserves a mention too ...

​All too often women are not told about vaginal oestrogen, but it is a local form of HRT that works in and around the vagina, vulva and bladder area rather than throughout the whole body.

It can help with vaginal dryness, soreness, painful sex, irritation, bladder symptoms and recurrent UTIs.

NICE says vaginal oestrogen should be offered for genitourinary symptoms of menopause, even if you are already using systemic HRT, and explains that only a minimal amount is absorbed into the bloodstream.

​The NHS also says vaginal oestrogen does not have the same risks as other types of HRT because the dose is low and very little gets into the rest of the body. For many women, this can be a small treatment that makes a very big difference.

Vaginal oestrogen is available as a cream, pessary, vaginal tablet and a ring such as Estring, which is usually replaced every three months. The best option is simply the one that suits your symptoms and feels easiest to use.

My own GP says she feels all women over 50 should be offered vaginal oestrogen.

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Menopause voices and resources I trust

One thing that has helped me enormously is reading and listening to women and medical experts who explain menopause in a way that is clear, practical and empowering.

I always anchor the medical information in this blog to sources such as NICE, the NHS and the British Menopause Society, because those are the references I want readers to be able to check for themselves.

But I also think there is huge value in patient-friendly education.

Dr Louise Newson has been one of the most helpful voices for me. Her resources explain menopause, HRT, body-identical hormones, progesterone and individualised prescribing in a way that makes sense when you are trying to understand your own body.  She has an excellent book, The Power of Hormones.

Kate Muir’s book, Everything You Need to Know About the Menopause, is also a brilliant place to start. Kate was involved in the Channel 4 documentaries with Davina McCall, which really did help bring menopause into the mainstream conversation and made many women feel less alone.

Davina McCall deserves a mention too, because her documentaries Sex, Myths and the Menopause and Sex, Mind and the Menopause helped so many women start asking questions, booking appointments and realising they were not imagining their symptoms.

I have also found the Liz Earle Wellbeing content helpful, especially for women who want practical, everyday information alongside the medical guidance.

I do think these voices have helped open up the conversation and encouraged women to learn more, ask better questions and feel less ashamed about wanting help.

I also want to mention the late Professor John Studd, because I first found his work when I was researching progesterone intolerance and trying to understand why that part of HRT felt so difficult for me.

Professor Studd was a pioneer in the field of menopause, PMS, osteoporosis and hormone-responsive depression. The London PMS & Menopause Clinic describes itself as the legacy of Professor Studd and says he started the first menopause clinic in Europe in 1969. I still attend his clinic and see Mr Michael Savvas, who has specialist experience in menopause, HRT, PMS and reproductive endocrinology. Mr Savvas also developed his interest in reproductive endocrinology when he was a Research Fellow to Professor Studd at King’s College Hospital.
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Progesterone intolerance was such a big part of my own HRT journey. Finding clinicians who understood that, rather than dismissing it, made an enormous difference.

My final thoughts

If you have been frightened by some of the scare stories in the press or you haven't fully understood how HRT can help you, then I hope this blog has been useful and reassuring.

For me, HRT has been life-changing. Moving from compounded hormones to regulated HRT, then from patch to gel and eventually to an oestrogen implant, has taken time, research, appointments, blood tests, specialist support and a lot of patience.  But I was determined!

And now I feel so much better. I am more stable. I tolerate my progesterone. I feel more like myself. And I feel reassured that, with proper reviews and specialist guidance, I am making an informed choice that supports both how I feel now and how I hope to age.

Every woman deserves the chance to understand the options and get the support she wants.

Please do not rely on one frightening social media post or a friend’s opinion. Do your own research, read reliable sources, track your symptoms, ask questions, book an appointment, book a review and ask for a referral if you need one.

And most importantly don't give up even if you feel you are being fobbed off - try again!  We all deserve to be heard.

Over the last ten years of blogging, I have shared many useful menopause resources including podcasts, books, menopause specialists and useful websites - please do take a look.

And please do leave a comment, email me or find me on Instagram, I'd love to hear from you.  And don't forget to subscribe to blog updates if you haven't already.

Love from
Michelle xx

A quick disclaimer:

This blog is based on my own personal experience, research and understanding of HRT.

I am not a doctor, menopause specialist or medical professional, and nothing in this article should be taken as medical advice.  HRT is a prescribed treatment and every woman’s situation is different. Your age, symptoms, medical history, family history, personal risk factors and the type of HRT being considered all matter.

Please speak to your GP, menopause specialist or another qualified healthcare professional before starting, stopping or changing any medication. If you feel dismissed or unsure, it is okay to ask for a review, a second opinion or a referral to someone with more menopause experience.
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I have included the main reference links below so you can read more from NICE, the NHS, the British Menopause Society and other menopause resources I have found helpful.

​NICE: Menopause identification and management, NG23
NICE: NG23 update information
NHS: Hormone replacement therapy overview
NHS: About hormone replacement therapy
NHS: Benefits and risks of HRT
NHS: Vaginal oestrogen
British Menopause Society: Bioidentical HRT consensus statement
British Menopause Society: BMS & Women’s Health Concern recommendations on HRT in menopausal women
NHS Business Services Authority: Hormone Replacement Therapy statistics, England
NHSBSA: Hormone Replacement Therapy, England, April 2015 to June 2025
Dr Louise Newson: Menopause and HRT resources