Side effects of HRT
Common aspirin, taken by multitudes for the effective eradication of common symptoms such as a headache, causes side effects in a proportion of the populace, as does paracetamol – most, if not all, treatments have the potential for side effects. This is therefore to be expected and true too for HRT.
For some women their negative reaction to components of HRT is so severe that they are unable to take it, while for others the benefits of HRT outweigh the impact of the side effects. Quite often the side effects, such as headaches, bloatedness or breast fullness are transient and resolve once the woman settles on the HRT, usually within a couple of weeks. Sometimes it is necessary to change the type of HRT to minimize side effects. Here is a list of the more frequently experienced side effects:
Side effects related to the hormone Oestrogen – breast tenderness, leg cramps, skin irritation, bloating, indigestion, nausea, headaches.
Side effects related to the hormone Progesterone - premenstrual syndrome-like symptoms, fluid retention, breast tenderness, backache, depression, mood swings, pelvic pain.
There are effective ways of minimizing, or indeed even eradicating, these side effects. Thus nausea can be reduced by taking the HRT tablet at night with food instead of in the morning, or by changing from tablets to another type of HRT such as transdermal patches. While some women will complain that they put on weight as a result of taking HRT, in fact research has shown that HRT does not cause weight gain.
Weight gain in middle age (the so-called “middle-age spread”) is an undesirable reality, not caused by HRT. Researchers have found that, although women may put on some weight when they first start to take HRT due to a degree of reversible fluid retention, after a while their weight is the same as it was before treatment. Women whose energy levels and positive outlook on life following commencement of HRT find that they exercise more, and are therefore more likely to lose weight.
Irregular bleeding on HRT:
Monthly sequential preparations should produce regular, predictable and acceptable period like bleeds. Erratic breakthrough bleeding is common in the first 3-6 months of continuous combined and long-cycle HRT regimens (with no regular period like bleeds). If there is persistent irregular vaginal bleeding after six months of starting HRT, you will need to have further investigations. If you experience significant nausea or migraine headaches with oral preparations, patches can often be a better option. Progesterone related side-effects can often be minimised if the Mirena coil (intrauterine system) is used as the progesterone arm of HRT.