Hormone Replacement Therapy (HRT) for Menopause in Singapore
HRT for menopause typically involves cyclic HRT, a therapy that combines two hormones, estrogen and progestogen, which are two hormones that are commonly given together to relieve bothersome symptoms of menopause.
HRT treatment can help relieve menopause symptoms such as:
- Hot flushes
- Night sweats
- Vaginal dryness
- Low mood or anxiety
- Sleep disturbances
- Bone thinning (osteoporosis)
Many women don’t realise that estrogen plays a protective role across the entire body—including your skin, bones, heart, and brain. When those levels fall during menopause, the effects ripple widely.
Different Types of HRT Treatments
There are various types of hormone replacement therapy (HRT) available. Some routines can be cyclical (sequential) or used daily (continuous).
Each HRT medication has its own regimen, just as different treatments cater to individual needs and life stages. Here’s an overview of commonly prescribed HRT treatments in Singapore:
Estrogen-Only HRT
- Usage: Two types – transdermal and oral. Transdermal is usually used for genitourinary syndrome of menopause that does not adequately respond to moisturisers and lubricants.
- Note: Suitable for women who have undergone a hysterectomy.
- With Intact Uterus: A separate progestogen may be prescribed for 10–14 days each month to induce a withdrawal bleed, reducing the risk of endometrial hyperplasia (abnormal womb lining growth).
Continuous Combined HRT
- Usage: One tablet daily without breaks, at the same time each day.
- Composition: Each tablet contains both estrogen and progestogen.
- Ideal For: Postmenopausal women aiming to avoid monthly hobleeding.
Continuous Estrogen & Cyclic Progestogen HRT
- Pack Composition: 14 estrogen-only tablets followed by 14 combined estrogen and progestogen tablets.
- Usage: One tablet in the specified order daily, without breaks between packs.
- Outcome: Withdrawal bleeding typically occurs once a month after completing each pack.
Triphasic Therapy
- Pack Composition: Estrogen-only tablets and combined estrogen-progestogen tablets in varying doses.
- Usage: One tablet daily in the correct order, without breaks between packs.
- Outcome: Monthly withdrawal bleeding is normal.
Cyclic Estrogen and Progestogen
- Pack Composition: 11 white estrogen-only tablets followed by 10 brown combined estrogen and progestogen tablets.
- Usage: One tablet daily for 21 consecutive days, then a 7-day tablet-free interval.
- Outcome: Withdrawal bleeding usually occurs during the seven-day tablet-free interval.
The type of HRT your doctor prescribes depends on different factors and requires careful consideration. If you would like to find out more about the other kinds of HRT other than the one you are currently prescribed, you can always check with our doctor. We’re always here to help guide you toward the best options for your body.
Note: For women with an intact uterus, estrogen-only HRT may increase the risk of endometrial hyperplasia. That’s why progestogen is included in HRT treatments—to help protect the womb and also support regular menstrual bleeding.
How Should I Take HRT Medication?
Here’s a simplified guide:
- Take HRT after food to reduce nausea.
- Take it at the same time each day for consistency.
- Follow the pill order carefully—You must take the tablets in the correct order, as some tablets contain only estrogen while others contain both estrogen and progestogen.
- Each pack will have a seven-day tablet-free interval, during which you will experience withdrawal bleeding (menses) except for Continuous HRT.
- Do not stop abruptly without medical advice.
If you miss a dose:
- Please take it as soon as you remember.
- Skip doubling up—continue as usual the next day.
- Missing multiple pills may cause spotting or withdrawal bleeding.
Storage:
Store in a cool, dry place away from sunlight and children.
What Are the Side Effects of HRT?
Common Side Effects
These may occur in the early months of treatment as your body adjusts to the hormones:
- Breakthrough bleeding or spotting
This refers to light bleeding between your periods. It’s common during the first few months or if doses are missed. If it persists beyond the initial months, appears later during treatment, or continues after stopping HRT, do consult your doctor. - Mood changes
Hormone fluctuations can affect your emotional state. Taking your HRT at the same time daily can help stabilise hormone levels and reduce mood swings. - Breast tenderness, mild bloating, or fluid retention
These symptoms are usually temporary and tend to improve over time. - Nausea and vomiting
Taking your medication with food can help reduce these effects. - Headaches
These can be managed with simple pain relievers like paracetamol and staying well hydrated.
Increased Risks
HRT may slightly increase your risk of blood clots and breast cancer, especially with long-term use. While on HRT, it’s advisable to check your breasts regularly. If you notice any unusual lumps, changes in size, or persistent discomfort, consult your doctor promptly.
Rare but Serious Side Effects
- Heavy or prolonged menstrual bleeding
- Dark urine, pale stools, yellowing of the eyes or skin, persistent nausea or stomach pain (may suggest liver issues)
- Noticeable mood disturbances that affect daily life
What to Know Before Starting HRT
- Before prescribing any HRT for menopause, we always:
Review your medical history
Discuss your personal menopause experience
Discuss side effects, precautions and contraindications
The Prologue to a New Chapter
Menopause is not an ending—it’s a transition. And with the right support, it can be a beautiful one. At Prologue, we don’t just treat symptoms; we care for the whole woman. With HRT for menopause, we aim to help you live vibrantly, comfortably, and confidently
If you’ve been wondering whether HRT could help you feel more like yourself again, this is your invitation. Let’s start with a conversation.
Book a consultation at Prologue, and let’s rewrite your next chapter together.
FAQ
What should I take note of before taking HRT?
Inform your doctor if:
- You have any known allergies to this medication or its ingredients.
- You are pregnant, planning to conceive, or currently breastfeeding.
- You are taking any other medications — including over-the-counter supplements, traditional remedies, or herbal products.
- You have a history of or currently have medical conditions such as liver disease, stroke or heart conditions, blood clots, migraines, epilepsy, diabetes or any form of cancer.
Does HRT cause weight gain?
HRT medication doesn’t directly cause weight gain. Instead, shifting hormones, reduced muscle mass and slower metabolism are usually to blame. In fact, for some women, HRT helps maintain weight by improving energy and sleep—making it easier to stay active.
We always remind our patients that pairing HRT with a nourishing diet and strength-based movement can help them feel better in their bodies, not just their hormones.
Who might HRT not be suitable for?
We know menopause is personal—and we take your safety seriously. While HRT treatment in Singapore is generally safe under medical supervision, it may not be recommended if you
- Are allergic to HRT medication ingredients
- Are pregnant or planning to be, or breastfeeding
- Are on other medications, supplements, and traditional or herbal remedies
- Have a history of liver problems, stroke, heart disease, blood clots, migraines, epilepsy, diabetes, or cancer
- Are scheduled for surgery soon (you may need to pause HRT temporarily)
If any of these apply to you, don’t worry—our clinic offers non-HRT alternatives for menopause.
What happens after stopping HRT?
When you stop HRT, your body will gradually return to its natural postmenopausal hormone levels. Some symptoms like hot flashes, mood swings, or vaginal dryness may return, this largely depends on how long you were on HRT, the type you used, and your body’s natural hormone balance. It’s best to taper off HRT under medical supervision to reduce the risk of symptom rebound.
Is it OK to stay on HRT for life?
The standard recommendation for duration of menopausal hormone therapy (MHT) use has been five years (and not beyond age 60 years). For women who are not at increased risk for breast cancer or cardiovascular disease, the benefits of MHT outweigh the risks until approximately age 60.
Extended use of MHT is defined as more than five years or beyond age 60 years.
Does HRT make you look younger?
While HRT isn’t an anti-aging treatment per se, it can have visible effects. Estrogen helps support skin elasticity, hydration, and collagen – so some women notice firmer, smoother skin and fewer wrinkles. Improved sleep and mood from HRT can also subtly reflect in your overall appearance. That said, the goal of HRT is to support well-being, not reverse aging.