If more than one year has passed since your last period, you should probably take hormone therapy continuously – that is, some estrogen with or without progesterone every day. Read on to learn how this works and why it is important.
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 been 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. Other medical issues can mimic menopause symptoms.
Likewise, 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 – there are alternative, non-hormonal medications, 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 little 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 continuous HT?
If you are over 45 and you haven’t had a menstrual bleed for at least one year, you have probably had your last period. This means that you have passed menopause and are now postmenopausal.
If this is the case, and you decide that HT is right for you, it is usually best for you to take continuous HT. This means that your prescription contains the same amount of hormones every day.
It can sometimes be tricky to decide if you have been through menopause – for example, if you have a medical condition that means you don’t have regular periods, or if you take medication that stops them, such as some types of contraception. If you aren’t sure, speak to your healthcare provider. They will be able to advise you where you are in your menopause journey, and which type of HT is best for you.
Are there different types of continuous HT?
Two types of hormone are used for HT: estrogen and progesterone. You will need to take estrogen every day to control your menopause symptoms.
If you do not have a uterus (for example, if you have had a hysterectomy), you can take estrogen-only HT continuously with no other hormones.
However, if you still have your uterus, you need to take both estrogen and progesterone. This is because progesterone protects the uterine lining from the effects of estrogen. If taken alone, estrogen can cause abnormal thickening, which can progress to cancer. Progesterone provides effective protection against this.
Therefore, if you still have your uterus and you are postmenopausal, you need continuous combined HT containing both estrogen and progesterone every day.
Continuous combined HT is available as patches or pills, or you can take separate forms of estrogen and progesterone.
Read more about different types of HT.
Will I have periods when using continuous HT?
No. You should not have periods when using continuous HT. If you do, speak to your doctor. They may advise adjusting your dose of one or both hormone or switching to cyclical HT.
It is also important to note that irregular bleeding can be a common side effect in the first weeks and months of an HT prescription, and can take up to six months to settle.
If this happens to you, keep a note of when the bleeding happens and let your healthcare provider know. This is especially important if you still have bleeding after six months, as there is more risk that it needs to be evaluated.
Once you stop having bleeding – including early bleeding from starting HT – you should always see your healthcare provider if you have any bleeding after menopause, including bleeding after sex. This is known as postmenopausal bleeding, and needs checking out urgently. In most cases this is due to a common and benign problem like fibroids or genitourinary syndrome of menopause (GSM), but it can sometimes be a sign of cervical or endometrial cancer.
Read more about the risks and benefits of HT.
Final word
Continuous HT is a highly effective treatment for menopause symptoms, and it’s prescribed when it’s been more than a year since your last period. If you think this type of HT would be a good fit for you, speak to your healthcare provider.
Find out more about menopause on our blog or in our symptoms library.
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