Side effects of HRT

A summary of the side effects and risks of HRT



Menopause Advisor
@EileenDurward
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Minor side-effects of HRT

If you are not struggling with your symptoms of menopause, then taking HRT may make the experience more difficult. HRT rarely comes without its side effects. However, in the main, these side-effects are mild and usually preferable to severe symptoms of the menopause. Common side-effects include:

Venous Thromboembolism

This is the situation when blood clots form in the veins of the body. There are two common areas where clots can form as a side effect of HRT:

  • Deep Vein Thrombosis (DVT) – this is when a blood clot forms in one of the deep veins in the body, typically in the lower leg or thigh. Symptoms will include swelling of the leg or calf accompanied by pain.
  • Pulmonary Embolism (PE) – this is the condition which occurs if part of a blood clot present because of a DVT breaks off and travels to the lung.

Both DVT and PE are known medically as Venous Thromboembolism. The risks appear to be higher when taking Continuous Combined Therapy (CCT) rather than oestrogen-only HRT, and the risk is also higher in the first year of taking HRT.

Cancer in the breast, ovary or uterus

A small increase in the risk of these cancers has been reported as a side effect of HRT.

  • Breast tissue is highly sensitive to oestrogen and progesterone. The longer the body is exposed to these female hormones, the higher the likelihood of developing breast cancer. Continuous Combined Therapy (CCT) increases the risk of breast cancer more than oestrogen-only HRT.
  • The risk of developing cancer of the ovary slightly increases if HRT is taken. This risk decreases again once HRT is stopped.
  • Oestrogen in HRT increases the risk of cancer of the uterus. By taking CCT, the risk is reduced, and this is part of the reason why progesterone is included in HRT. There is no need to take progesterone if you have had a hysterectomy.

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Stroke

Another side effect of HRT is an increased risk of developing a stroke. This is a condition where the blood supply to the brain is affected, causing damage to the brain, and loss of brain function.

High doses of oestrogen (ie. more than 50 micrograms) increase the risk more than low doses. However, the risk of a stroke is higher from lifestyle factors such as smoking, obesity and high blood pressure.

Heart disease

Heart disease is very common in the western world. This condition affects the arteries of the heart and is the cause of angina and heart attacks.

There is a small increased risk of heart disease as a side effect in women who have begun using Continuous Combined Therapy (CCT) more than 10 years after their menopause. However, there is no evidence to suggest that oestrogen-only HRT increases the risk of heart disease.

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