HRT for runners: A guide to hormone replacement therapy - Women's Running

HRT for runners: A guide to hormone replacement therapy

Author: Juliet McGrattan

Read Time:   |  June 13, 2022

Dr Juliet McGrattan explains HRT for runners (hormone replacement therapy) and whether it can help your running

The British Menopause Society tell us that 75 per cent of women get symptoms from their menopause and 25 per cent of these women class their symptoms as severe. The range of symptoms that the falling hormone levels of the menopause can bring is huge. From the well-known (and much dreaded) hot flushes and night sweats to brain fog, palpitations and joint aches, every system of the body can be affected. Replacing those falling hormone levels with Hormone Replacement Therapy (HRT) can give good relief from symptoms for many women. HRT can seem a complicated and confusing topic so here’s a quick rundown of what you need to know considering HRT for runners.

Do I need HRT?

You’ve reached the menopause when you haven’t had a period for 12 months. The time leading up to that point, when many women experience symptoms, is called the peri-menopause. This can last several years. The average age of the menopause in the UK is 51. Not every woman will want or need HRT but these are the situations when it should be used, or at least considered through a discussion with a health care professional:

  • Your symptoms are having a negative impact on your day to day life
  • You’ve had an early menopause (age less than 45), whether that be premature ovarian insufficiency (POI) or after surgery to remove your ovaries
  • There’s a need to prevent or treat osteoporosis

Types of HRT for runners

The two main ingredients in most HRT are oestrogen and progestogen. Progestogen is needed to keep the lining of the uterus healthy. If you’ve had a hysterectomy (removal of the uterus) then you don’t usually need the progestogen and may be prescribed oestrogen alone.

The oestrogen and progestogen preparations come in two different types:

  • Cyclical HRT: Oestrogen is given every day and progestogen is given for two weeks every month. It can be used for two weeks every three months in some women.
  • Continuous combined HRT: Oestrogen and progestogen are taken together every day. This is only suitable if you are post-menopausal (not had a period for a year).

Testosterone is another hormone that falls during the menopause. As a form of HRT, its use is currently quite restricted in the NHS: it’s mainly used for women who have a low sex drive and you’d need to see a menopause specialist to have it prescribed.

HRT can be given in lots of different ways:

  • Oral (by mouth) as a tablet
  • Transdermal (through the skin) as a gel, patch or cream
  • Implant of oestrogen as an under the skin implant, progestogen in an intrauterine system (IUS) i.e. a coil which releases progestogen
  • Vaginal: oestrogen can be given as a cream, gel or vaginal ring to release oestrogen into local tissues. It can be used by all women and without progestogen.

The risks of HRT for runners

Every woman’s risks are individual and relate to her own medical history as well as that of her family but HRT is now thought to be safe for the vast majority of women. The benefits it brings can be life changing, provide huge relief from symptoms and outweigh the risks for most women. It’s important to discuss your own situation with your nurse or doctor to determine what is right for you. Two of the biggest concerns that women have are:

  • Breast cancer. Oestrogen HRT alone is thought to pose little or no increased risk. When combined with progestogen there may be a minimal increased risk related to how long you take it and this risk reduces when you stop it. HRT is not thought to increase your chance of dying from breast cancer. Remember that being overweight or drinking more than 14 units of alcohol per week pose a bigger risk for breast cancer than HRT.
  • Venous Thromboembolism (VTE). There is a small risk of developing clots such as deep vein thrombosis (DVT) or pulmonary emboli (PE) when using a tablet HRT but this risk is not present when using transdermal routes.

How can HRT help my running?

HRT is primarily used to help reduce symptoms of the menopause. Many of those menopause symptoms have a negative effect on your running. HRT may not help you manage all your menopausal problems but here are some of the running-related benefits you might experience:

  • Improved sleep and fewer night sweats which gives you better recovery and more energy
  • Reduced hot flushes making indoor exercise easier
  • Stabilisation of your mood which improves your enjoyment of running
  • Reduced vaginal dryness making running more comfortable
  • Fewer joint and muscle aches and pains
  • Less fatigue so you have more energy to run

Problems with HRT and running

It’s important to be aware that any medication you take can have side effects. Some of the side effects of HRT can have a negative effect on your running. Every woman is different and for most, the benefits they get from HRT will outweigh the problems.

Side effects that affect running include:

  • Breast tenderness
  • Bleeding
  • Headaches
  • Nausea
  • Indigestion

Remember, it takes time to settle on HRT and many side effects will fade or go after a few weeks. If they haven’t eased after three months, or are severe, see your doctor to try an alternative.

How long does HRT take to work and how long can I use it for?

Don’t be fooled by reports of women who say they felt dramatically different after one day of HRT! It normally takes a few weeks. A three-month trial will give a good indication as to whether it’s the right HRT for you. Once you’re settled on it you will be reviewed by your doctor or nurse every year to make sure that the benefits still outweigh the risks for you and that no changes are needed to your HRT preparation. There’s no upper age limit to when it can be used for most women. Until you don’t want or need it any more is the general advice but speak to your doctor before you plan to stop it.

Juliet McGrattan

Health expert, author, keen runner and busy mum

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