What are the side effects if you stop HRT suddenly?
WITH much work being dedicated to destigmatising the menopause in recent years, growing numbers of women know to spot the symptoms and have opted for hormone replacement therapy (HRT).
But in that time, shortages of the drugs have also plagued the supply chain, leading many to share the vital medicines as pharmacies struggle to get hold of them.
Reports also emerged last year that certain forms of HRT could increase your risk of breast cancer.
Whether you're choosing to come off the treatment or can't access it, you might be wondering if there are any side effects from coming off HRT.
Are there side effects to stopping HRT suddenly?
Most people going through the menopause will stop taking HRT once their symptoms abate.
This is usually two to five years after they start the treatment, according to NHS Inform, but it can be longer for some.
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If you're thinking about stopping HRT, the (NICE) says you can do so immediately or gradually.
But it notes you should speak to a GP before doing so, so they can advise you about the best option for you.
Meanwhile, recommends gradually reducing your dose of HRT as you wean yourself off it.
This is because it's possible that you'll experience some of the menopausal symptoms the drugs were keeping at bay once you stop taking them.
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According to NICE and the NHS, they may return less quickly if you stop taking HRT gradually.
Health and vitamin expert states that milder forms of HRT - like topical creams for vaginal dryness - can be stopped immediately, but recommends you wean yourself of HRT medication over a two-to-four-month period.
"Your GP may advise lowering your HRT dose, cutting HRT pills in half, or using a patch with reducing doses," it wrote.
"You should not come off HRT suddenly or go ‘cold turkey’.
"If you stop HRT abruptly, your hormone levels will fluctuate from high to low within a short amount of time.
"As a result, your body may go into ‘overnight menopause’, and bothersome symptoms may quickly reappear."
Even if you manage your HRT withdrawal well, it is still likely that you'll experience some symptoms coming off it - but these should subside after a few months.
NHS Inform noted that you should speak to your GP if your menopausal symptoms persist "several months after you stop HRT" or if they are "particularly severe", as you may need to restart treatment.
This will usually be a lower dosage to what you were on before.
It's possible you might still need to manage vaginal dryness after you come off the treatment, which can be done by using cream, lubricants and local oestrogen preparations.
What are the side effects when you start HRT?
Though HRT can be a lifesaver to many suffering from debilitating menopause symptoms, it's also possible you can experience side effects from the treatment.
It also depends on whether you opt for oestrogen or progestogen.
According to the NHS, common side effects from oestrogen include:
- bloating
- breast tenderness or swelling
- swelling in other parts of the body
- feeling sick
- leg cramps
- headaches
- indigestion
- vaginal bleeding
But these should subside after a few weeks.
Try taking your oestrogen with food to dampen the symptoms of sickness or indigestion, and do some exercise or stretching to ease your leg cramps.
Eating a low-fat, high-carbohydrate diet, may reduce breast tenderness, NHS guidance added.
If side effects persist, your GP may recommend switching to a different way of taking oestrogen - for example, changing from a tablet to a patch - changing the medicine you're taking, or lowering your dose.
Side effects from progestrogen should also pass within a few weeks and include:
- breast tenderness
- swelling in other parts of the body
- headaches or migraines
- mood swings
- depression
- acne
- tummy (abdominal) pain
- back pain
- vaginal bleeding
While the benefits of taking HRT usually outweigh the risks, combined HRT has been associated with a small increase in risk of breast cancer.
The NHS wrote: "The increased risk is related to how long you take HRT, and it falls after you stop taking it.
"Because of the risk of breast cancer, it's especially important to attend all your breast cancer screening appointments if you're taking HRT."
Some HRT tablets can also slightly increase your risk of blood clots, but patches and gels won't do that.
The meds may not be suitable if you:
- have a history of breast cancer, ovarian cancer or womb cancer
- have a history of blood clots
- have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
- have liver disease
- are pregnant – it's still possible to get pregnant while taking HRT, so you should use contraception until two years after your last period if you're under 50, or for 1 year after the age of 50
How does HRT work?
HRT is a treatment to relieve symptoms of the menopause and works by replacing hormones that are at a lower level as you approach this period of your life.
Experts have warned that the menopause can be responsible for a range of 62 symptoms in people going through it.
Some of the most common ones include:
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- hot flushes
- night sweats
- mood swings
- vaginal dryness
- reduced sex drive
