You can take hormone therapy (HT) if you are still having periods – you just have to take it in a slightly different way. This way of taking HT is called cyclical HT. Read on to learn more about why you might be prescribed cyclical HT.
What is hormone therapy (HT)?
Hormone therapy (HT) is a treatment for menopause symptoms. It can also protect the health of your bones and heart and reduce your risk of cancer and diabetes. It comes in the form of pills, patches, creams, and gels, among others. It has consistently proven to be the most effective treatment for a range of menopause symptoms such as mood changes, hot flashes, painful sex, and bladder symptoms.
It’s important that you discuss any symptoms with your healthcare provider to be sure of your diagnosis before you consider HT treatment. This is because other medical issues can sometimes mimic menopause symptoms.
HT may not be suitable for you because of your medical history or you may just prefer not to take it. That’s ok, HT isn’t for everyone – alternative, non-hormonal medications are available and lifestyle change can help too. Your healthcare provider will help you make an informed decision.
HT, HRT, and MHT – what’s the difference?
Research and self-education can improve your menopause experience and speed up the process of finding the right treatment for you. Confusing terminology can get in the way of this! We want to clear things up if you have come across the terms HRT, HT, or MHT and you’re not sure what they mean. The truth is, there is no difference in the meaning of these abbreviations.
- HRT stands for hormone replacement therapy. Many symptoms of menopause are caused by a dramatic reduction in levels of certain hormones such as estrogen. This name suggests that the medication works by replacing the hormones that are no longer produced by your body during menopause
- HT, or hormone therapy, is a term that is growing in popularity as the way to describe this type of treatment. Hormone-based medications that treat menopause symptoms do not technically ‘replace’ hormones. It is more accurate to say that the hormones in HT safely and effectively treat symptoms caused by changes in your body during menopause
- MHT, or menopausal hormone therapy, is a more precise phrase than HT. Hormones are used in lots of different medical treatments, so MHT is used to specifically describe HT for menopause and is often preferred by research scientists for this reason. You may see this phrase used in scientific research papers
What is cyclical HT?
If it has been less than a year since your last period, you should probably take HT in a cyclical, or sequential, way. Monthly cyclical HT is when you take estrogen every day, and also take progesterone for the last 10 to 14 days of your cycle, depending on the type of hormone prescribed.
This variable level of hormones allows your body to have a regular, period-like bleed and keep the lining of the uterus healthy. Importantly, it reduces the chances of unpredictable, irregular bleeding when taking HT.
It’s a common misconception that you can’t take HT if you’re still having periods. This is absolutely not true. If you are still having your periods you CAN take HT.
Perimenopause is the phase of menopause that happens before your periods stop. During this time, you will be experiencing hormonal changes and this is often the point at which menopause symptoms are at their worst. HT can be really beneficial at this time.
Read more about the stages of menopause.
Does cyclical HT stop periods?
Probably not. You will very likely still have bleeds on cyclical HT. These are caused by the hormones in your HT and they are often referred to as ‘withdrawal bleeds’ rather than periods. They will seem very similar to normal periods although tend to be lighter and more regular, especially if you have been having heavy or irregular periods as you approach menopause.
You should have a bleed each month if you’re taking monthly cyclical HT.
How do your HT needs change with age?
Your HT needs will change as you go through menopause.
It’s common to need to adjust your dose of HT. As time passes, you may find that you need more or less estrogen to control your symptoms. This is normal and reflects the continued change in your body’s own estrogen levels as you progress through menopause.
When you reach menopause itself, meaning that you have gone a year or more without a period, your HT needs will probably change. You’ll move from taking hormones cyclically to taking them continuously. Continuous HT involves taking estrogen – and progesterone if you have a uterus – every day.
This switch will generally happen after two to five years on cyclical HT, or when you are over the age of 54. It can be tricky to decide when you have reached menopause if you don’t have regular periods. Your healthcare provider will be able to advise you when it is time to switch.
Final word
Cyclical HT is an option for you if you’re still having periods but struggling with menopause symptoms.
HT is very effective at treating menopause symptoms but it is not suitable for everyone.
Find out more about menopause on our blog or in our symptoms library.
- Stella, HT after your periods have stopped
- Stella, Different types of HT
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