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  • What are the different types of HRT?

Find your options for hormonal replacement therapies to help ease symptoms of menopause

Hormonal replacement therapy (HRT) is a type of treatment aimed at helping women going through menopause. It can help with symptoms such as:

  • hot flushes
  • night sweats
  • mood swings
  • lower libido (sex drive)
  • vaginal dryness

But with multiple forms and doses, it’s difficult to know which type of HRT will work best for you. Keep reading to find out how different hormonal replacement therapy options compare against one another.

Medically reviewed by Dr. Anand Abbot MRCGP Written by our editorial team Last reviewed 12-01-2024

What are the different forms of HRT?

Hormonal replacement therapy can be taken as tablets, a skin patch (similar to a plaster), or as a gel.

Different forms have different advantages based on your personal preferences and medical history, as well as whether you are perimenopausal or menopausal.

The different forms of HRT

HRT oral tablets

Tablets are the most common type of HRT, and include brand names such as:

In general, you have to take 1 tablet every day, preferably at the same time.

Hormonal replacement therapy tablets can be either combined (oestrogen and progesterone), or oestrogen-only.

Please note: These tablets can put you at a higher risk of developing blood clots compared with the patch or gel (even though the risk is still minimal).

This is because your liver increases blood-clotting factors when it processes oestrogen. Consult a doctor if you have any concerns.

HRT patches

Patches can be stuck to your skin with adhesive, a bit like a plaster. Normally they need to be replaced every few days.

Hormonal replacement therapy patches include brand names such as:

The patch can also be combined or oestrogen-only.

Unlike tablets, the patch doesn’t run the risk of blood clots because the hormones are absorbed through the skin and avoid the liver.

Topical HRTs

HRT can also be applied in a topical form, where the hormones are absorbed through the skin.

Topical gel/cream

Some gels are rubbed into the skin daily, usually on the arm. These only contain oestrogen. Like the patch, the hormones are absorbed through the skin and also avoid the liver.

Topical spray

Alternatively, you can use a spray containing oestrogen. Apply the spray to either your forearm or inner thigh. Do not apply it near your breasts.

For both creams, gels, and sprays, let the treatment absorb into the skin before getting dressed and avoid bathing for 60 minutes.

Intravaginal HRT

Some forms of HRT are applied inside the vagina to help increase hormone levels. This can help with vaginal dryness and discomfort during sex.

Vaginal tablet

Brands like Vagifem offer vaginal HRT tablets. Insert one tablet daily for 2 weeks, then reduce to 2 tablets per week.

Vaginal cream or gel

You can insert HRT vaginal creams like Estriol (Gynest), Ovestrin, or Blissel. Apply daily for 3-4 weeks, then reduce dose to just twice weekly.

Vaginal pessary

Insert a pessary every night for 3 weeks, before lowering the dose to one pessary twice a week.

Vaginal ring

Brands such as Estring offer vaginal rings that release oestrogen. These must be inserted into the top third of the vagina and replaced every three months.

Tablets Patches Topical Gel Intravaginal Vaginal rin
How often are they taken? Daily Every few days Daily Daily for 3 weeks, then twice weekly Every 3 months
Increased chance of blood clots?
Is it available as combined?
Is it available as oestrogen only?

What hormones are in HRT?

Hormone replacement therapy uses oestrogen or a mix of oestrogen and progesterone. The hormones can be natural or made synthetically.

Some women can also be prescribed testosterone gel to help improve a low libido - however, this has not yet been licensed and is only available off-label.

Below is a table showing the different hormones in alternative HRT treatments:

Oestrogen-only Oestrogen and progesterone
  • Everol
  • Elleste (solo)
  • Premarin
  • Kliofem
  • Zumenon
  • Estriol (Gynest)
  • Everol Conti
  • Elleste (duet)
  • Femoston
  • Femoston Conti
  • Kliovance
  • Premique

Oestrogen-only

All HRT treatments contain some form of the hormone oestrogen.

Oestrogen-only HRTs are generally only prescribed to women who have had their wombs removed (via a hysterectomy).

This is because this type of HRT is known to be linked Trusted source PubMed Government Source Database of Biomedical Research Go to source with causing cancer of the womb. If your womb has been removed, then you are no longer at risk.

Oestrogen and Progesterone

Combined HRT (containing both oestrogen and progesterone) is prescribed to women who still have their wombs.

By taking both hormones you limit the risk of developing endometrial cancer.

You can still take oestrogen-only HRTs if your womb is intact, as long as you combine it with a progesterone supplement. Consult your doctor about dosage and how often it should be taken.

An exception:

Livial is another type of HRT. It contains something called tibolone, which is a kind of steroid. Tibolone imitates how oestrogen, progesterone, and testosterone work in the body.

Which HRT is right for me?

Because there are so many types of hormonal replacement therapy, it is best to have a consultation with a doctor to figure out which one is most suitable for you.

It might take several months for your body to adjust to your chosen treatment. It doesn’t mean it’s not working if your menopausal symptoms don’t improve straight away.

Consider which form of HRT you’d prefer to take, whether it’s tablets, a patch, or applying a cream.

Also opt for a combined HRT if you haven’t had a hysterectomy.

HRT comparison

Use our comparison table to see how different brands of hormonal replacement therapy compare.

You can click on up to 4 products at once:

Can I buy HRT online?

You can purchase HRT online here at HealthExpress.

Consult your GP about starting HRT to get a prescription for a suitable treatment. Once you know which type to take, select your choice and order online with free next-day delivery.

Your treatment will be sent in discreet packaging straight to your front door.

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