Hormone replacement therapy - HRT - is treatment with oestrogen, or oestrogen and progestogen, to replace natural substances produced by a woman's body. Oestrogen and progestogen control the menstrual cycle (periods) for about 30 years from puberty onwards. Most of these two hormones are produced by the ovaries. Lack of oestrogen causes the symptoms which occur at the menopause ("change of life"). Replacing hormones by giving HRT can relieve these symptoms.
How am I going to feel?

Many of the symptoms which women experience at the time of the menopause are due to lack of oestrogen. Whether you are going through your natural menopause or one caused by treatment, HRT may be able to relieve some of these symptoms. You may also experience an increase in general well-being. In addition, HRT protects against osteoporosis in two out of three women and halves the risk of heart disease. This is particularly important if you have an early menopause (before 45 years old).

How is HRT given?
HRT can be given in several ways: by mouth through a self-adhesive patch as an implant under the skin as a cream to rub into the skin There is no evidence that one method is better than another - you may prefer tablets to patches or vice versa. Your doctor may wait to see how HRT suits you before suggesting an implant. Whichever form of HRT you take you will receive oestrogen continuously. On oestrogen tablets you will need to take them continuously. If you have been prescribed combined therapy, with progestogen, you may need to take progestogen tablets continuously or for 12 days in every 28.

With HRT patches they should be applied to clean, dry, unbroken skin below the waist. You place the patch on your lower abdomen or buttocks. Never place it on or near your breasts. The patch should be removed and replaced with a new one every three to four days. Place it near the old patch site. You can continue to bathe or shower as usual when wearing patches.
With implants, a pellet containing oestrogen can be placed under the skin. This is done during a minor operation using local anaesthetic. An implant needs to be renewed every four to six months. Again you will be prescribed progestogen tablets if you haven't had a hysterectomy.

Ask your doctor, who will be able to advise you if HRT is right for you. HRT isn't suitable for every woman. Discuss with you doctor any side effects that may occur while taking HRT, how long you will have to take them for. It is always best to write down any questions you have for your doctor and take them with you.

Before coming off HRT or deciding on any alternatives always discuss it with your doctor first as it may be better for some women to be on HRT.
Some women do not want to take HRT for many reasons. They may be in a high risk category for Breast Cancer or they may be at risk of Thrombosis. Or they may just not like taking drugs.

A few of the vitamins are........
Calcium is vitally important in the health of the bones and extra calcium after the menopause may help to reduce the loss of bone that occurs. It is as important to get adequate amounts of Vitamin D as this is used by the body as a bone strengthener and allows the body to absorb calcium effectively. Vitamin D is usually made naturally by the body when it is exposed to sunlight and it can also be found in fish, egg yolks and cereals. However those that find it difficult to get out in to the sun may find that taking supplements helps.

Vitamin E is an important vitamin to consider at the menopause. Over many years clinical studies have shown its effect on reducing hot flushes. Vitamin E is also helpful for vaginal dryness. It can also be used internally inside the vagina every night for about six weeks to help relieve dryness.

Vitamin B is called the 'stress' vitamin because they are enormously beneficial when you are under a great deal of pressure. Symptoms of B-vitamin deficiency include anxiety, tension, irritability and poor concentration. Therefore, supplementing them in the form of a good B-complex supplement can be useful if you have any of these symptoms of stress.
Magnesium is an important mineral for your bones at the menopause so it is important that you have enough in your body. Magnesium is also known as 'nature's tranquilliser', so it will help with symptoms such as anxiety, irritability and other mood changes.

There are a number of herbs that have traditionally been used at the menopause. The main ones are termed 'adaptogens', which have a balancing effect on the body.
Black Cohosh, a herb used by the Native North Americans, is very effective in restoring female hormonal balance and helps to relieve menopausal symptoms such as hot flushes and vaginal dryness.
This is by far the most potent remedy for hot flushes as it contains the chemical precursors of the sex hormones. It stimulates and normalises the function of the pituitary gland which controls and balances the hormones in our body. This is one of the most important herbs you can take at the menopause because it works as an adaptogen, generally balancing all hormone production.

There are hundreds of natural plant extract, vitamins and creams available from health shops to take during the menopause, some combined with taking HRT, there really are too many to list here.
Some of the plant extracts should not be taken with HRT, the pill or certain medications so always check with your GP first.