How do oestrogen tablets, patches, gel and spray work?
Oestrogen is a type of hormone replacement therapy (HRT). HRT works by replacing the hormones that fall during and after the menopause, which helps to improve menopause symptoms.
Most oestrogen medicines contain a type of oestrogen called estradiol that comes from plants. It's identical to the oestrogen your ovaries produce before the menopause.
As you go through the menopause your levels of oestrogen fall, causing symptoms such as hot flushes, low mood and vaginal dryness or irritation.
Taking oestrogen as HRT increases your levels so that they are similar to before the menopause. This reduces your symptoms and also helps makes your bones stronger.
When will I feel better?
It can take up to 3 months for hormone replacement therapy (HRT) to work fully in improving your symptoms.
There are different types of HRT, and it can take time to find the type and dose that works for you.
If you do not feel better after 3 months, speak to your doctor. They may suggest changing your dose, or switching to a different type of HRT.
If you're taking oestrogen for osteoporosis you're unlikely to notice any difference in how you feel, but the oestrogen will be helping make your bones stronger.
Are there any long-term side effects?
It's best to only take HRT at the lowest dose that works for you, and only for as long as you need it to control your menopause symptoms.
This is because HRT can slightly increase the risk of breast cancer and blood clots. The risk is small, but it increases the longer you take it.
Usually, the risk is outweighed by the benefits of HRT, such as improving menopause symptoms, quality of life and preventing osteoporosis. But this depends on your age, symptoms and health. Speak to your doctor, who can help you decide.
How does it compare with other types of HRT?
There are several different types of HRT. They all work equally well to replace the hormones that fall during and after the menopause.
There is not 1 type of HRT that is suitable for everyone. You may need to try different types to find what works best for you.
Most oestrogen medicines contain a type of oestrogen called estradiol that comes from plants and is identical to the oestrogen that your body produces. Other types include conjugated oestrogen (called by the brand name Premarin), but this is now less commonly used.
If you still have your womb, you'll need to take oestrogen tablets, patches, gel or spray with a separate progestogen medicine such as Utrogestan (micronised progesterone).
There are other types of HRT that combine oestrogen and progestogen in one medicine. These are available as patches, tablets or capsules:
- sequential combined HRT, for if you're still having periods
- continuous combined HRT, for if you're no longer having periods
You can also get your progestogen by using the intrauterine system (IUS), also known as the Mirena coil or hormonal coil. This can be useful if you have side effects from other forms of progestogen, if you have heavy periods, or if you also need contraception.
There are also several types of vaginal oestrogen. These are effective for symptoms such as vaginal dryness, and you can use them alongside other types of HRT. However, they do not treat other menopause symptoms such as hot flushes.
Your doctor can help you decide on the type of HRT that's best for you.
How does it compare with alternatives to HRT?
Hormone replacement therapy (HRT) such as oestrogen tablets, patches, gel and spray is usually the most effective treatment for menopause symptoms.
If you cannot take HRT, or prefer not to take it, your doctor may be able to recommend other medicines or lifestyle changes to help with your symptoms.
Medicines such as pregabalin, clonidine and some antidepressants (such as fluoxetine or sertraline) are sometimes used as an alternative to HRT to help with symptoms such as mood swings.
What will happen if I stop taking it?
If you stop taking oestrogen your menopause symptoms might come back.
If you're taking it for osteoporosis there is a chance that your bones will get weaker and you may be more likely to have fractures in the future.
Talk to your doctor if you're thinking of stopping. They will help you decide what's best for you. They may suggest that you reduce your dose gradually, to help stop symptoms coming back.
If you're having problems with side effects, your doctor might suggest changing your dose, or switching to another type of HRT.
Can I switch to another brand or type of HRT?
Some brands of oestrogen are very similar and it's possible to switch between them without any problems.
Speak to a doctor or pharmacist if the brand or type of HRT you've been using is not available because of supply shortages, or is not helping your symptoms, or if you have problems with side effects. They can advise about switching to a different type.
Can I get HRT for free?
You'll need to pay for your hormone replacement therapy (HRT) prescriptions unless you're eligible for free prescriptions.
However, you can reduce the cost by getting an HRT pre-payment certificate (PPC). This means you can pay a small fee that will cover all your HRT prescriptions for a year.
Find out how to save money with a prescription prepayment certificate.
Will I gain or lose weight?
There is no good evidence that taking oestrogen makes you put on weight.
However, it's common to gain weight around the time of the menopause. Eating a balanced diet and exercising regularly will help you keep to a healthy weight.
Will it affect my contraception?
Oestrogen is not a contraceptive.
It's still possible to get pregnant while taking hormone replacement therapy (HRT), so you'll need to use contraception until 2 years after your last period if you're under 50 years old, or for 1 year if you're over 50 years old.
You'll usually need to use a non-hormonal method of contraception, such as condoms or a diaphragm, or other options which you can speak to your doctor about.
If you need to take progestogen with your oestrogen, it's possible to use the intrauterine system (IUS), also known as the hormonal coil or Mirena coil. This works as a contraceptive as well as giving you the progestogen that you need to protect your womb.
Talk to your doctor or a pharmacist if you have any questions about contraception and HRT.
Can I drive or ride a bike?
Yes, taking oestrogen does not affect your ability to drive or ride a bike.
Can I drink alcohol while taking oestrogen tablets, patches, gel or spray?
You can drink alcohol while taking oestrogen but it may be helpful to cut down on alcohol during the menopause to reduce symptoms of flushing, and improve your sleep.
Is there any food or drink I need to avoid?
You can eat and drink normally while taking oestrogen.
Try to have a healthy, balanced diet, as this can help with menopause symptoms and keep you well.
Cutting down on alcohol and caffeine may help reduce hot flushes and improve your sleep.
Can lifestyle changes help menopause symptoms?
The following lifestyle changes can sometimes help with menopause symptoms:
- Regular exercise. This helps with bone health and can reduce hot flushes and improve your sleep. It may also help improve your general mood, reduce stress and help you keep to a healthy weight.
- Cut down on caffeine and alcohol. This may help reduce hot flushes and improve your sleep.
- Quit smoking. This can help reduce hot flushes and reduce your risk of developing other health problems such as cancer, heart disease and stroke.
Find out more about lifestyle changes for menopause symptoms