As Mr Hamoda explains: ‘Studies have shown that gels and patches have a lower risk profile than oral oestrogen.
This is because they deliver the hormone through the skin and into the bloodstream, where it is diluted and breaks down slowly before reaching the liver, so it doesn’t affect the clotting system in the liver and therefore does not increase the risk of stroke or blood clots as HRT containing oral oestrogen might.’But your GP can prescribe newer plant-based formulations of HRT, which are created from plants such as soya and wild yam.
‘A sudden stop to HRT means oestrogen receptors throughout the body switch from full to empty, and the impact in terms of symptoms can be similar to a sudden menopause,’ she says.
The effect can be reduced by switching to a lower dose HRT for three to six months before stopping.
Haitham Hamoda, a consultant gynaecologist who leads the menopause unit at King’s College Hospital London, and is a member of the British Menopause Society’s Medical Advisory Council, speaks for many of his peers when he says the health risks of HRT are actually ‘very small when put into context’. Some women do not like the idea of taking hormones, and aren’t willing to consider any risk at all.