During perimenopause and menopause, the ovaries gradually produce less estrogen and progesterone. For many women, this causes symptoms that affect sleep, mood, comfort and quality of life. Hormone replacement therapy (HRT) replaces some of these hormones to relieve symptoms, and can also help protect bone health.
HRT isn’t right for everyone. A careful assessment of your symptoms, health and personal risks helps you and your doctor decide whether it’s a good choice.
For men with symptoms of low testosterone, see Men’s Check Up. For transgender people, see Gender-Affirming Hormone Therapy.
Menopause Symptoms
- Hot flashes and night sweats
- Sleep problems
- Mood changes, irritability or low mood
- Vaginal dryness and discomfort during sex
- Reduced libido
- Urinary symptoms, such as urgency
- Joint aches
- Difficulty concentrating
Who Might Benefit from Hormone Replacement Therapy?
HRT may be suitable if you:
- Have menopausal symptoms such as hot flushes, night sweats, sleep disturbance, low mood or vaginal dryness that affect daily life
- Went through menopause early — before 45, or before 40 (premature ovarian insufficiency) — when HRT is usually recommended at least until the average age of natural menopause
- Have had your ovaries removed surgically
- Are at increased risk of osteoporosis, including a family history of fragile bones
- Have tried lifestyle changes or other treatments without enough relief
For most women under 60, or within 10 years of their last period, the benefits of Hormone Replacement Therapy generally outweigh the risks. Your doctor will talk through your individual situation.
Who Should Not Take HRT
HRT may not be suitable, or may need a specialist approach, if you have:
- Current or past breast cancer, or another hormone-sensitive cancer
- A history of blood clots (deep vein thrombosis or pulmonary embolism)
- Active liver disease
- Unexplained vaginal bleeding that has not yet been investigated
- Uncontrolled high blood pressure
- A recent heart attack or stroke
- A current or possible pregnancy
If any of these apply, don’t rule treatment out on your own — non-hormonal options and low-dose vaginal oestrogen may still be possible.
Assessment Before Starting
- Consultation: your symptoms, menstrual history, medical and family history, and personal preferences.
- Physical examination: including blood pressure, weight and a pelvic examination where appropriate.
- Tests: such as blood tests for lipids, blood sugar and liver function, a mammogram, cervical screening and, where needed, bone density.
- A personal treatment plan: your doctor explains the expected benefits and risks before you decide.
Possible Side Effects and Risks
Common side effects, which often settle within the first few months, include:
- Breast tenderness
- Bloating or fluid retention
- Headaches
- Nausea or indigestion
- Irregular bleeding or spotting in the early months
- Mood changes
Less common but more serious risks include:
- Blood clots, mainly with oral oestrogen
- Stroke, a small increase with oral HRT
- Breast cancer, a small increase in risk with combined HRT that rises with length of use and falls after stopping
- Endometrial (womb) cancer, if oestrogen is taken without progestogen by a woman who still has a uterus
Your doctor will explain how these risks apply to you personally and choose the approach with the best balance of benefit and safety. Report any unexpected bleeding, calf pain or swelling, chest pain or sudden breathlessness straight away.
Follow-up and Ongoing Care
Your first review usually takes place about three months after starting treatment, to check how well your symptoms have improved and adjust the dose if needed. After that, most women are reviewed at least once a year. Keep up with routine breast screening throughout treatment.
Menopause care often goes hand in hand with other checks. A Women’s Check Up covers wider screening, and if sleep remains a problem, our Sleep Disorder (Insomnia) service can help. For vaginal dryness or discomfort during sex, Vaginal Rejuvenation and Improve Sexual Wellness offer further options.
Why Choose Kamol Hospital in Bangkok for HRT
- Women’s health under one roof: HRT alongside women’s check-ups, vaginal rejuvenation and vaginal tightening.
- Careful assessment: Your risks are reviewed before any treatment is prescribed.
- Individualized treatment: The type, dose and form of HRT are chosen to suit you.
- Ongoing monitoring: Regular reviews to keep treatment safe and effective.
- Private and comfortable: Discreet consultations with experienced doctors.
- Hospital-level standards: A JCI-accredited hospital.
Frequently Asked Questions
Is Hormone Replacement Therapy safe?
For most healthy women under 60, or within 10 years of menopause, the benefits usually outweigh the risks. Safety depends on your personal history, the type of HRT and how it is taken, which is why a full assessment comes first.
How long can I stay on Hormone Replacement Therapy?
There is no fixed time limit. Many women use HRT for several years, and some for longer. Your doctor will review whether it is still right for you at least once a year.
Will HRT make me gain weight?
Research has not shown that HRT itself causes weight gain. Weight changes around midlife are common with or without treatment. If weight is a concern, ask about our Weight Reduction Therapy programme.
Is it worth travelling to Bangkok, Thailand, to start Hormone Replacement Therapy?
Many international patients combine their HRT consultation with a health check or another planned treatment at Kamol Hospital. Because HRT needs ongoing monitoring, we will give you a clear written plan and results you can share with your doctor at home, so your care continues smoothly after you leave Thailand.
Are doctors in Thailand experienced in menopause treatment?
Yes. Thailand’s leading private hospitals, including those in Bangkok, have specialist gynaecologists and follow international guidance on menopause care. At Kamol Hospital, doctors experienced in women’s hormonal health lead your treatment.
Can I use HRT if I only have vaginal symptoms?
Yes. Low-dose vaginal oestrogen treats dryness, irritation and some urinary symptoms directly, and very little enters the bloodstream. It can often be used even when full HRT isn’t recommended.
