Through the work of Davina McCall, there has never been a better time to discuss hormone replacement therapy. In this blog we discuss the different types and how safe they are.

Before we start, I need to express that I am not a doctor and therefore cannot prescribe HRT, but I do work with women every day who ask me about it and so I like to keep up to date with the latest research to help guide them with their choices. 

And while I use natural methods to achieve hormone balance, I am definitely not against body identical HRT. I have clients who find it’s a game changer and others who simply cannot get on with it and take themselves off it. Then there are those who cannot take it for health reasons and those who’ve had early menopause or a hysterectomy for whom HRT is vital.

In any event, I always think it’s better to get the basics right first, i.e. hormone balance through diet and lifestyle modifications, and then, if needed, add in the HRT. This way, it can offer the maximum benefit with the minimum side effects. If this is something you would like help with, please get in touch. We can run private tests to see exactly what is happening in your body and then put together the best plan for you (note: testing is not essential to make progress)

In my opinion, if we don’t deal with the root cause, such as gut, liver, adrenal and thyroid issues, we are unlikely to feel the full benefit of the HRT.  As mentioned above, it is, after all, only replacing 2 of our sex hormones. It doesn’t address any of the other hormones that intricately work together. 

Either way, the choice is ours and not one we should worry about. Rather we should take the time to make an informed decision and that is where our GP and this blog will hopefully help.

Is HRT safe?

In the 2002 the Women’s Health Initiative published its study to say that HRT increased the risk of heart disease, stroke and breast cancer. This HRT used was Premarin- made from pregnant horses urine (yes, I’m being serious!) and synthetic progestogens. The consequence of this research was that many women stopped taking their HRT and it is now believed that this may have caused 50,000 women to have died prematurely. It is worth mentioning, at this point, that the risk of breast cancer is much higher if we are obese or drink excess alcohol, than these synthetic forms of HRT. 

Fortunately now we have access to body identical oestrogen, made from wild yams and soya which are chemically identical to our hormones. We also have body identical progesterone and, to date, there is no evidence that these forms of HRT carry any additional risks to us as our body treats them the similarly to our own hormones.

What are the different forms of HRT?

  1. Body identical– this is one that most NHS GP’s are now prescribing (although you may have to ask to be sure as some are still prescribing the synthetic versions!). 

Their names are-


  • Gels- Oestrgel and Sandrena
  • Patch- Estradot, Evorel, Elleste Solo, Estraderm, FemSeven Mono and Progynova
  • Spray- Lenzetto

Unlike oral oestrogen, these methods have the added benefit of by-passing the liver which means fewer side effects as well as a lower blood clotting risk.

Progesterone (micronized):

  • Utrogestan 100mg capsules
  1. Bio identical– given out only by private doctors, these practitioners are also able to prescribe other hormones such as DHEA and testosterone. They give doses that are ordered exactly for your needs by the dispensing pharmacy, but have been criticised by some medical professionals for not being as well regulated.


  • We live, on average, 30 years in menopause and we want those years to be fabulous!
  • To date, body identical HRT is safe and effective.
  • HRT can help reduce the risk of osteoporosis, heart disease and dementia.
  • HRT is not for everyone, some cannot take it and others do not need it. 
  • NHS blood tests may not give the full picture.
  • Privately we can test your levels over the period of a whole day, measure your testosterone, oestrogen, progesterone, DHEA and cortisol as well as whether your liver is choosing the most effective/safest way to metabolise your oestrogen and much more. See the functional testing page for more details.
  • Diet and lifestyle changes should be made either before or alongside your HRT for maximum benefits get in touch if you would like help with this.