Many women choose to take HRT for a much longer period of time than a few years. This is often because they feel better and have more energy when taking hormone replacement therapy; they also want to protect their future health from long-term conditions associated with low estrogen levels, such as osteoporosis and cardiovascular disease. All women taking hormone therapy should have an annual review with their doctor or nurse. If you're staying healthy and feeling the benefits of taking hormone replacement therapy, there's no reason to stop to take it.
Women are often surprised when menopausal symptoms return after stopping hormone replacement therapy, even those women who have taken it for many years. As we've already mentioned, menopausal symptoms can last for more than a decade. There is some evidence that shows a slightly increased risk of heart attack or stroke during the first year after stopping hormone therapy. As always, decisions about your health should be made by weighing all the relevant information and deciding what is best for you, and in consultation with your health professional.
If you've been through menopause, you may not notice anything at all. Some people feel that there is nothing special about stopping hormone therapy and there are no symptoms. You can take hormone replacement therapy (HRT) if you have menopausal symptoms, including during perimenopause and after your periods stop (postmenopause). These depend on the type of hormone therapy you're taking, but may include an increased chance of breast cancer and blood clots (including deep vein thrombosis and pulmonary embolism).
This fact sheet includes information to help you decide if now is the right time to start or stop taking HRT, even if menopause occurred several years ago. However, the myth that you have to stop taking it after five years is still one of the most common reasons women stop taking it. If you've weighed the information in this fact sheet and decide that leaving HRT is the right decision for you, it's generally recommended that you decrease your estrogen dose gradually, every few days, for a few weeks. At this consultation, they will check how well hormone replacement therapy is working and discuss the benefits and risks of continuing with hormone therapy.
The combination pill can mask or improve menopausal symptoms because it contains estrogens, which are also used in hormone replacement therapy. This is often because doctors refuse to continue prescribing it, in the erroneous belief that the administration of HRT has a maximum safety limit of five years, regardless of the woman's age or the reason she is taking it. This doesn't mean that you have to keep receiving hormone replacement therapy for the rest of your life, but simply that you should wait a little longer before you stop taking it. In this case, you should plan to continue with hormone replacement therapy at least until the average menopausal age (51 years in the UK)).
If menopausal symptoms come back when you try to stop taking it and you decide that the benefits of HRT for your symptoms still outweigh the risks, you can keep taking it for longer. The longer you take HRT, the greater your risk of developing one of these conditions as a result of using HRT. The recent shortage of supplies has also caused problems, as many women discontinue hormone therapy because they couldn't get their usual patches or formulations. The British Menopause Society reports that there is no strict limit as to the duration of hormone therapy and that continued treatment depends on your individual circumstances.
If your regular doctor doesn't consider hormone replacement therapy for you, you may want to find a doctor or nurse who has a special interest in menopause.
