Dealing with side effects

• There is no evidence that HRT causes weight gain
• Side effects can be categorised into Estrogenic and Progestogenic

Estrogenic side effects

• Breast tenderness/enlargement: Reduce dose of estrogen or change route. OTC Purchase: Evening Primrose oil, starflower oil.
• Bloating Nausea: Take with food or change route
• Headache: Change route
• Leg cramps: Change route

Progestogenic side effects

• There are 2 groups of progestogens: testosterone derived and progesterone derived
• Women who have troublesome side effects from a progesterone in the testosterone group may find these side effects improve if they try a progesterone from the progesterone group and vice versa
• Testosterone derived: Norethisterone, Norgestrel, Levonorgestrel
• Progesterone derived: Medroxyprogesterone, Dydrogesterone, Drospirenone
• Known side effects are PMS type symptoms, Breast tenderness, Lower abdominal pain, Backache, Depressed mood, Acne/greasy skin & Headaches
• Give progesterone by LNG-IUS (Mirena coil) to avoid side effects
• If postmenopausal, change to continuous combined HRT or tibolone as this avoids symptoms of progestogen fluctuation

http://www.menopausematters.co.uk/sideeffects.php