Menopausal Hormone Therapy (MHT) is another name for Hormone Replacement Therapy (HRT). It includes a range of hormonal treatments which boost hormone levels which can help with symptoms of perimenopause/menopause.

These hormonal treatments include:

1. Estrogen - Usually a body identical estrogen in the form of a patch (or gel). Can also be in the form of an oral pill (slightly higher clotting risk).
2. Progestogen* - If you have a uterus, you will need a type of medicine called a progestogen (either progesterone* - body identical or progestin* - synthetic version) to protect the lining of the uterus from growing too thick (risk of endometrial cancer*). This may be in the form of a micronised progesterone (body identical) capsule, a progestin tablet, or a Mirena (intrauterine device) which releases low amounts of a progestin (levonorgestrel) to the uterus.
   For people who have had a hysterectomy, while you don't need progesterone, some still like to take some for its calming and sleep effects (can also be protective for people who have endometriosis and/or still have their cervix).
   
3. Testosterone - As levels lower with age, some women find taking testosterone can help with some of their symptoms.

Although not technically MHT we will also talk about Topical Estrogen (cream or pessary) for in the vagina which helps with local symptoms (vaginal dryness/less lubrication, pain with vaginal penetration, itchy vulva/vagina, UTI/bladder infections).

Definitions:

Progestogens are a group of medicines which all act similarly to natural progesterone in the body.

Progesterone is the version which occurs naturally in our bodies and is also the same in the Utrogestan capsules.

Progestins are the synthetic versions.

Endometrium is the lining of the uterus.

Endometrial cancer is a form of uterine cancer that's located in the lining of the uterus.

Rima Chakrabarti and Rini Chakrabarti British Journal of General Practice 2023; 73 (732): 330-332. DOI: https://doi.org/10.3399/bjgp23X733473