For Her · Menopause Care
HRT and menopause, explained properly.
Around three in four women experience menopausal symptoms, and for about one in four they are severe (NICE NG23). Hormone replacement therapy is the most effective treatment for many of them — and deciding whether it's right for you is a clinical conversation, not a guess.
Perimenopause and menopause — what's happening
Menopause is the point twelve months after your last period — in the UK the average age is 51. Perimenopause is the years leading up to it, when oestrogen and progesterone levels begin to fluctuate and fall. Symptoms can start years before periods stop, which is why perimenopause is so often missed or misattributed.
Common symptoms include:
- Hot flushes and night sweats (vasomotor symptoms)
- Irregular or changing periods
- Sleep disturbance and fatigue
- Low mood, anxiety or irritability
- Brain fog — trouble with memory and concentration
- Joint and muscle aches
- Vaginal dryness and discomfort
- Changes in weight and body composition
Most women experience some of these; the pattern and severity vary widely. If you're over 45 with typical symptoms, NICE guidance says perimenopause and menopause can be diagnosed clinically — without blood tests (NICE NG23).
What HRT is, and the forms it takes
HRT replaces the hormones your body stops producing — usually oestrogen, combined with progesterone if you have a womb (to protect the womb lining). Most patients notice improvement in vasomotor symptoms within four to twelve weeks (NICE NG23).
| How it's used | Worth knowing | |
|---|---|---|
| Patches | Stuck to the skin and changed once or twice a week; oestrogen-only or combined. | Through-the-skin (transdermal) oestrogen is not associated with the increased risk of blood clots seen with tablets (NICE NG23). |
| Gel and spray | Applied to the skin daily; the dose can be adjusted finely. | Also transdermal, with the same clot-risk advantage; needs separate progesterone if you have a womb. |
| Tablets | Taken daily by mouth; oestrogen-only or combined. | Simple to take; carry a small increased risk of blood clots compared with transdermal routes (NICE NG23). |
| Local (vaginal) oestrogen | Creams, pessaries or rings used vaginally. | Treats vaginal and urinary symptoms specifically; can be used alongside systemic HRT. |
The right form, dose and combination depend on your symptoms, health history and preferences — an individualised clinical decision, reviewed over time. Benefits and risks differ by age and by route; your clinician talks these through before anything is prescribed (NICE NG23).
How menopause care will work at Curate
We're building menopause care the same way we build everything: a confidential online assessment, a named UK clinician reviewing your health profile, treatment dispensed by our GPhC-registered pharmacy, and reviews built into the plan — initiation, titration and monitoring, not a one-off script.
The service isn't live yet. If you'd like to know when it opens, or want to talk to us about your options in the meantime, get in touch.
Menopause care is coming to Curate
Clinician-led HRT with initiation, titration and monitoring by a named UK clinician. Register your interest and we'll let you know when it opens.
Questions
HRT and menopause, answered.
How do I know if I'm perimenopausal?
If you're over 45 with typical symptoms — changing periods, hot flushes, sleep disturbance, mood changes or brain fog — NICE guidance says perimenopause can be diagnosed clinically, without blood tests (NICE NG23). Under 45, blood tests may play a role, and a clinician should assess you either way.
Is HRT safe?
No medication is risk-free, but for most women under 60 with menopausal symptoms, the benefits of HRT outweigh the risks (NICE NG23). The balance depends on your age, health history and the type of HRT — transdermal oestrogen (patches, gel) is not associated with the increased clot risk seen with tablets. It's an individual decision made with a clinician.
How quickly does HRT work?
Most patients report improvement in hot flushes and night sweats within four to twelve weeks (NICE NG23). Sleep, mood and other symptoms often follow. Doses are usually reviewed after three months and adjusted if needed.
What's the difference between patches, gel and tablets?
They deliver the same hormones by different routes. Patches and gel absorb through the skin and avoid the small increased clot risk associated with oral tablets; tablets are the simplest to take. The right form depends on your health history and preference — your clinician will talk it through.
When will menopause care be available at Curate?
We're building the service now — clinician-led HRT with initiation, titration and monitoring by a named UK clinician. Get in touch via our contact page and we'll let you know when it opens.
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