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Find answers to common questions about hormone replacement therapy.

Should I stop taking hormone replacement therapy (HRT)?

The answer depends on how long you've been taking hormone replacement therapy, and why.

HRT is very effective at helping to control menopause symptoms.

However, HRT causes a small increase in a woman's risk of developing breast cancer, endometrial cancer, ovarian cancer and having a stroke.

As well as risks, there are other benefits. HRT can also reduce a woman’s risk of developing osteoporosis, colon cancer and cancer of the rectum.

The NHS says that used for no longer than 5 years, the benefits of HRT outweigh the risks.

Anyone taking HRT for longer should discuss the risks and benefits with their doctor.

What else can I do to prevent symptoms of menopause?

There are several alternative remedies you may want to try to reduce menopausal symptoms such as hot flushes or night sweats:

Soya: Soya seems to be an effective, short-term treatment to suppress hot flushes and night sweats. For instance, a 2002 study published in the US journal Menopause, concluded: “Soy isoflavone extract may help to reduce the frequency of hot flushes in climacteric women and provides an attractive addition to the choices available for relief of hot flushes.” It can be difficult to get enough soya from food, so many women use a soya protein powder in fruit shakes. However, soya may be potentially dangerous for women with a history of oestrogen-dependent cancer of the breast, uterus or ovaries.

Black cohosh: Some studies suggest that black cohosh may be helpful in the very short term (six months or less) for treating hot flushes and night sweats. Black cohosh is registered for sale in the UK as a traditional herbal medicine for the relief of symptoms associated with the menopause, such as hot flushes, night sweats, poor sleep, temporary mood changes, irritability, slightly low mood and mild anxiety. However, unlike licensing for mainstream medicines, registration doesn't mean a herbal remedy has been tested and proven to actually work. Side effects include gastrointestinal upset or liver damage.

Antidepressants : Antidepressants, especially the SSRI group of antidepressants such as fluoxetine, have been shown to relieve hot flushes but may not be licensed for this use. One study in the Journal of Clinical Oncology looked at how well fluoxetine reduced hot flushes in 81 women with a history of breast cancer. Those taking fluoxetine reported 50% fewer hot flushes compared with a 36%reduction among women taking a placebo.

Lifestyle changes: Women can also reduce hot flushes by:

  • Dressing in layers, so they can remove clothes as needed.
  • Wearing natural fabrics, such as cotton and silk.
  • Keeping room temperatures cool or using a fan.
  • Sleeping with fewer blankets.
  • Drinking cold beverages rather than hot ones.
  • Limiting intake of caffeine and alcohol.
  • Eating smaller meals.
  • Not smoking.
  • Using relaxation techniques such as yoga.
  • Getting regular exercise.

For vaginal dryness or lost libido, here are a couple of options that may help:

  • Vaginal lubricant creams or jelly: These are better over-the-counter lubricants than oil-based petroleum jelly, and can be used safely with condoms. Keep in mind that vaginal dryness happens to all women to some degree as they age. But it affects the sex life of some women more than others. Lubricants help, but so does sex. Indeed, sexual activity, including masturbation and intercourse, maintains a woman's ability to lubricate.
  • Vitamin E oil: This common vitamin supplement can also be used directly in the vagina to increase lubrication and soothe the vaginal lining. Women can buy vitamin E oil capsules sold in most chemists and crack open a capsule to get the oil.
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