A Guide to Hormone Replacement Therapy and Your Treatment Options

If you’re experiencing symptoms of perimenopause or menopause, you’re not alone.

Common searches we see at Pharmulous include:

• “Best HRT for menopause”
• “HRT tablets vs patches”
• “What is continuous combined HRT?”
• “HRT for vaginal dryness”
• “Is HRT safe?”

Hormone Replacement Therapy (HRT) is one of the most effective, evidence-based treatments for menopausal symptoms. This guide explains how it works, which options are available, and how to choose the right type for you.

What Is HRT?

HRT replaces hormones (primarily oestrogen, and sometimes progesterone) that decline during perimenopause and menopause.

It can help relieve:

• Hot flushes
• Night sweats
• Mood changes
• Brain fog
• Vaginal dryness
• Sleep disturbance
• Joint aches
• Reduced libido

At Pharmulous, we offer a range of regulated, UK-licensed HRT treatments following clinical assessment.

Types of HRT Explained

The right HRT depends on:

• Whether you still have a uterus
• Whether you are perimenopausal or postmenopausal
• Your bleeding pattern
• Your preference for tablets, patches, or local treatment
There is no one-size-fits-all approach and safe prescribing requires individual assessment.

Continuous Combined HRT (No Monthly Bleed)

Continuous combined HRT contains both oestrogen and progesterone taken every day. It is usually suitable for women who are postmenopausal (12 months since last period).

Options available at Pharmulous include:

• Elleste Duet Conti
• Kliofem Tablets
• Kliovance Tablets
• Femoston-Conti Tablets
• Evorel Conti Patches

These treatments aim to:

• Relieve menopausal symptoms
• Protect the womb lining
• Avoid regular withdrawal bleeds

Patches such as Evorel Conti may be preferred by some women as they:

• Deliver hormones through the skin
• Avoid first-pass liver metabolism
• Provide steady hormone levels

Sequential (Cyclical) HRT

Sequential HRT is typically used in perimenopause when periods are still occurring.
It includes continuous oestrogen with progesterone taken part of the month, resulting in a predictable monthly bleed.

Available options include:

• Evorel Sequi Patches
• Elleste Duet (sequential formulations)
• Femoston Tablets (cyclical versions)

This approach helps manage symptoms while maintaining a structured cycle during the transition phase.

Oestrogen-Only HRT

If you have had a hysterectomy, you may only require oestrogen.
Options at Pharmulous include:

Tablets

• Elleste Solo Tablets

Patches

• Evorel Patches

Oestrogen-only therapy can effectively relieve:

• Hot flushes
• Night sweats
• Mood symptoms
• Sleep disturbance

Body-Identical Progesterone Options

For women using separate oestrogen therapy, progesterone may be required to protect the womb lining.
We supply:

• Utrogestan 100mg Capsules (micronised progesterone)
• Cyclogest Pessaries

Micronised progesterone is often described as “body-identical” and may be preferred by some women due to tolerability.

Your prescriber will determine whether progesterone is required based on your medical history.

Local (Vaginal) Oestrogen for Urogenital Symptoms

Many women experience:

• Vaginal dryness
• Discomfort during intercourse
• Recurrent urinary infections
• Urinary urgency

Local oestrogen treatment works directly at the site of symptoms and has minimal systemic absorption.

Available treatments include:

• Vagifem Pessaries
• Estriol 0.1% Cream
• Estriol 0.01% Cream

These are particularly helpful for women who:

• Cannot tolerate systemic HRT
• Only have urogenital symptoms
• Need additional local support alongside systemic HRT

HRT Tablets vs Patches: Which Is Better?

Both forms are effective. The choice depends on:

• Personal preference
• Risk factors
• Tolerance
• Lifestyle

Patches may be preferred if you:

• Experience nausea with tablets
• Have migraine
• Have risk factors where transdermal delivery is advantageous

Tablets may suit those who prefer a simple daily routine.

At Pharmulous, we assess suitability before prescribing to ensure safe and appropriate treatment selection.

Is HRT Safe?

HRT has been extensively studied. For most healthy women under 60 or within 10 years of menopause onset, the benefits often outweigh the risks when prescribed appropriately.

However, HRT is not suitable for everyone.

We may not prescribe if you have certain:

• Hormone-sensitive cancers
• Uncontrolled hypertension
• Active liver disease
• History of specific thrombotic events

Our prescribing process includes a structured medical assessment to ensure safe prescribing in line with UK guidance.

When Should You Consider HRT?

You may wish to explore HRT if menopausal symptoms are:

• Affecting your sleep
• Impacting your work or relationships
• Causing persistent discomfort
• Reducing quality of life

You do not need to “struggle through” symptoms.

Safe, Regulated HRT from Pharmulous

At Pharmulous, we provide:

• UK-licensed HRT medications
• Clinical review prior to prescribing
• Clear guidance on use
• Ongoing support

We stock a range of commonly prescribed HRT treatments, including:

• Elleste Duet Conti
• Kliofem
• Femoston
• Kliovance
• Evorel Conti & Evorel Sequi
• Elleste Solo
• Evorel Patches
• Vagifem
• Estriol 0.1% Cream
• Estriol 0.01% Cream
• Cyclogest
• Utrogestan

Treatment is only supplied following clinical assessment to ensure suitability.

Ready to Explore Your Options?

If you believe HRT may help manage your menopausal symptoms, you can begin a confidential online consultation today.

Our prescribing team will review your medical history and recommend a treatment plan tailored to you.

Menopause is a natural transition but suffering through symptoms does not have to be.