Key points

When helping someone decide if HRT is right for them, remember to:

• Discuss the benefits and risks of HRT before offering treatment. Provide information through signposting and allow the patient sufficient time to make an informed decision

• Discuss that HRT, when compared with a placebo, has been consistently shown to improve menopausal symptoms and overall quality of life. It remains the most effective treatment for menopausal symptoms for most women

• Deciding whether a person should take HRT, what dose they should use, their regimen and the duration of their use should be made on an individual basis. This should be done after discussing the benefits and risks with each patient. The overall benefits of using HRT should be considered, including symptom control and improved quality of life, as well as the bone and potential cardiovascular benefits associated with HRT use

• Transdermal administration of estradiol is unlikely to increase the risk of venous thrombosis or stroke above the risk in non-users. It is associated with a lower risk compared to oral administration of estradiol. The transdermal route should therefore be considered as the first-choice route of estradiol administration in women with related risk factors

• Discuss alternative treatments and non-hormonal options with women who are unable, or do not wish, to take HRT.