Hormone replacement therapy
Hardly any therapy has been as demonised and as hyped as this one. The truth lies in between: for the right woman at the right time, HRT is highly effective and safe — for others it is the wrong choice. We sort that out with you, based on your risk profile.
What HRT can do — and what it cannot
For vasomotor symptoms (hot flushes, sweats), hormone therapy is the most effective treatment there is. It often improves sleep, mood and urogenital symptoms and demonstrably protects bone. It is not an anti-ageing programme and no panacea — anyone selling you that is selling you something.
The risk chapter, without evasion
The famous 2002 WHI study gave HRT a decade of disrepute — with older preparations, older women and misinterpretations corrected today. Current state:
- Transdermal oestrogen (gel, patch) does not measurably increase thrombosis risk by current data — oral preparations do
- Breast cancer: combined HRT slightly increases risk (order of magnitude: a few additional cases per 1000 women over years) — comparable to risk factors like obesity or daily alcohol. Oestrogen-only therapy (after hysterectomy) does not show this signal
- Timing matters: starting under 60 or within ten years of menopause has the most favourable benefit-risk ratio
How we prescribe
Body-identical transdermal oestradiol plus micronised progesterone (with an intact uterus) is our standard — start low, titrate by effect. Before starting: history, blood pressure, breast and ultrasound status. Afterwards: a yearly benefit-risk review instead of rigid time limits. And if you want to stop, we plan it together — tapering, without drama.
Frequent questions about HRT
How quickly does it work?
Hot flushes often improve noticeably within two to four weeks; sleep and mood usually follow. After three months we take stock and adjust the dose.
Body-identical — is that not marketing?
The term is overused, but the core is right: transdermal oestradiol and micronised progesterone are structurally identical to the body’s own hormones and have the most favourable safety profile. We advise against individually compounded creams without approval, though.
Will the hormones make me gain weight?
The evidence shows: menopausal weight gain happens with and without HRT — it is metabolism, not a therapy effect. Some women actually maintain weight more easily on HRT because sleep and drive return.
What does it cost?
With symptoms of clinical significance, insurance usually covers the preparations. The detailed first consultation is covered; extended lab diagnostics without insurance indication we discuss transparently beforehand.
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Ask your questionHRT — yes, no, maybe?
Bring your history, we bring the evidence. At the end stands your decision — informed instead of unsettled.
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