Oestrogen Replacement for Women

There’s no strong evidence that oestrogen HRT causes weight gain. Many women notice changes in weight during perimenopause, but this is due to hormonal shifts, ageing, and lifestyle factors rather than HRT itself. Sometimes, when women start HRT they can experience bloating as a side effect. This can make women feel as if they have gained weight. However, this is a side effect and should settle within the first few months. In fact, HRT may help with body fat distribution by reducing the increase in abdominal fat linked to menopause.

"Oestrogen" is the UK spelling, while "Estrogen" is the American spelling. Both refer to the same hormone.

Yes, an imbalance of oestrogen—whether too high or too low—can affect mood. While declining oestrogen is often linked to anxiety in menopause, excessive oestrogen (especially without enough progesterone to balance it) may also contribute to symptoms like restlessness, irritability, or feeling on edge.

Excess oestrogen can sometimes cause:

• Breast tenderness
• Bloating
• Headaches
• Mood changes (such as anxiety or irritability)
• Heavier periods (if still menstruating)

If you are experiencing these symptoms on HRT, it is worth discussing your oestrogen dosage and balance with your doctor.

It depends. If you still have your uterus, you need progesterone alongside oestrogen to protect the womb lining from overgrowth, which could increase the risk of endometrial cancer. Progesterone can be provided orally with capsules and tablets, vaginally with pessaries or via the mirena coil.

However, if you have had a hysterectomy, oestrogen can be taken on its own without progesterone.

Yes, for many women, oestrogen can improve sleep. It helps regulate body temperature (reducing night sweats), supports mood, and can prevent the mid-night wake-ups often linked to menopause. However, if sleep issues persist, other factors like stress, diet, or lifestyle may need to be considered.

Vaginal oestrogen is a low-dose form of oestrogen applied directly to the vagina. It’s used to treat symptoms like dryness, discomfort during sex, and recurrent urinary infections. Unlike systemic HRT, vaginal oestrogen mainly stays in the local area and doesn’t significantly affect overall hormone levels.