An individualised approach should be taken with each person needing support with the menopause, refer to Menopause and Hormone Replacement Therapy page for diagnosis and management of people with symptoms of menopause.
Consider transdermal rather than oral HRT for menopausal people who are at increased risk of venous thromboembolism (VTE), including those with a BMI over 30 kg/m2.
-does not increase cardiovascular disease risk when started in women aged under 60 years
-does not affect the risk of dying from cardiovascular disease
-using transdermal oestrogen is NOT associated with an increase in the risk of stroke. The baseline population risk of stroke in women aged under 60 years is very low
-HRT with oestrogen alone is associated with no, or reduced, risk of coronary heart disease
-HRT with oestrogen and progestogen is associated with little or no increase in the risk of coronary heart disease
-the VTE risk associated with transdermal HRT given at standard therapeutic doses is no greater than baseline population risk.