Hormone Replacement Therapy (HRT) / Menopausal Hormone Replacement Therapy (MHT) in Singapore
Menopause marks a natural stage of life, but the transition can bring symptoms that disrupt well-being and daily routines. From hot flashes and sleep disturbances to changes in mood and energy, these shifts may feel challenging to navigate. Hormone Replacement Therapy (HRT) or Menopausal Hormone Therapy (MHT) offers a way to ease menopausal symptoms, helping women feel more comfortable and supported through this stage. Book a consultation with Dr Linsey Gani to help you determine if HRT/MHT is a suitable option for you.
What is Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)?
Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT) is a treatment designed to replace hormones that the body produces less of during and after menopause. It primarily involves oestrogen and progestogen, and in certain cases, specialists may also prescribe testosterone. HRT helps restore hormonal balance and can support long-term health by maintaining bone strength and protecting aspects of the reproductive system.
What are the types of Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)?
HRT/MHT can be categorised in three ways: by the type of hormones used, the form of treatment, and the treatment routine. This allows healthcare providers to personalise therapy according to individual needs, balancing effectiveness with safety and convenience.
| Category | Examples |
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Hormone used |
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Method of use |
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Treatment routine |
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What Are the Signs That You Need Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)?
Some women enter menopause with no symptoms or only very mild ones. However, if your symptoms are making daily life challenging, it may be time to consider HRT. Below are the most common signs of menopause transition that may signal a need to consider hormone replacement therapy:
- Hot flashes: Low oestrogen makes the hypothalamus in the brain more sensitive, triggering sudden surges of heat
- Night sweats: Hormonal changes may disrupt your body’s temperature control, causing sudden heat waves and excessive sweating during the night
- Chronic insomnia: Menopause can cause difficulty falling asleep or staying asleep, which may lead to tiredness, memory issues, and increased health risks.
- Joint pains: Declining oestrogen levels increase inflammation and reduce lubricant within the joints
- Mood swings: Shifts in hormone levels can intensify mood changes, making it harder to manage daily life.
- Sexual dysfunction: Reduced oestrogen can lower libido and cause vaginal dryness or discomfort during sex.
- Chronic vaginal itching and burning: Low oestrogen can cause vaginal atrophy, leading to dryness, inflammation, itching, and burning.
- Hair loss: Thinning hair may result from reduced oestrogen levels, though age, genetics, and nutrition can also contribute.
- Urinary problems: Low oestrogen can weaken the urethra, causing leaks with coughing, sneezing, or laughing, and sometimes difficulty reaching the bathroom in time.
You may consider HRT/MHT if menopause or perimenopause symptoms are affecting your daily life or overall well-being. If you’re unsure whether your symptoms are related to menopause, Dr Gani can assess your situation and advise whether HRT/MHT is suitable for you. Book an appointment with her now.
Benefits of Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)
HRT/MHT not only eases the symptoms of menopause but also supports long-term health, helping women maintain comfort, strength, and overall well-being. These are the main benefits that HRT offers:
HRT/MHT can ease common symptoms of menopause, such as hot flashes, night sweats, disrupted sleep, low mood, anxiety, and vaginal dryness, improving day-to-day comfort and quality of life.
By maintaining oestrogen levels, HRT/MHT can help preserve bone mass, reducing the risk of bone thinning and fractures that can come with osteoporosis. This is particularly important for women experiencing early or premature menopause, as starting HRT/MHT before the age of 45 can help protect long-term bone health.
Menopause often brings a gradual loss of muscle mass and strength. HRT/MHT may help preserve muscle function, supporting an active lifestyle and physical independence.
Menopause is often accompanied by genitourinary symptoms such as vaginal dryness, reduced lubrication during sexual activity, pain during intercourse, and decreased libido. Topical vaginal hormonal therapy may help alleviate these symptoms and improve comfort and sexual well-being.
Other Options For Hormone Replacement Therapy (HRT)/ Menopausal Hormone Therapy (MHT)
There are now other options available for systemic hormone therapy for the treatment of menopausal symptoms, namely tibolone and conjugated estrogen with bazedoxifene (CEE/BZA).
| Category | Tibolone | CEE with Bazedoxifene (CEE/BZA) |
|---|---|---|
Type | Synthetic hormone with estrogen, progesterone, and mild androgen effects | Estrogen combined with a selective estrogen receptor modulator (SERM) |
Main effects | May ease hot flashes, mood changes, sexual wellbeing, and bone health | May ease hot flashes, sleep, and mood symptoms, vaginal changes, and bone health |
Who may be considered | Postmenopausal women after medical review | Postmenopausal women with a uterus who prefer not to use added progestin |
Additional requirements | Suitability depends on the individual's health profile and the doctor’s assessment | |
How Much Does Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT) Cost in Singapore?
Hormone Replacement Therapy (HRT) in Singapore involves various costs, which can vary based on the type of consultation and medication prescribed. Menopause consultations with a menopause specialist typically range from $80 to $320, depending on the clinic and the complexity of the case.
On the other hand, the price of HRT medicines themselves can range widely depending on the form prescribed. For example, estrogen can be prescribed as over-the-counter estrogen creams, tablets or gels, which all vary greatly in price.
Risks of Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)
Overall, the risks of HRT/MHT are low, but they can vary depending on the type of HRT used, the duration of treatment, and individual health factors. Key risks include:
- Breast cancer: Combined HRT/MHT (estrogen and progesterone) is associated with a slightly increased risk of breast cancer, particularly with long-term use, while oestrogen-only HRT carries little or no increased risk; the risk declines after stopping HRT.
- Blood clots: HRT/MHT tablets can slightly increase the risk of deep vein thrombosis (DVT) and pulmonary embolism, but patches, gels, or sprays do not increase this risk.
- Stroke: HRT/MHT tablets may slightly raise the risk of stroke, especially in older postmenopausal women, whereas patches, gels, or sprays carry very low risk.
- Endometrial cancer: Women with a uterus who take oestrogen without progesterone are at increased risk of developing endometrial cancer.
- Ovarian cancer: Some evidence suggests a possible small increased risk with long-term HRT/MHT use, though data are not conclusive.
- Vaginal bleeding: Irregular or unexpected bleeding can occur, especially in women with a uterus, and should be evaluated promptly by a gynaecologist.
Side Effects of Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)
Most individuals experience only mild and temporary side effects, especially in the first few months of treatment. Common side effects include:
- Intermenstrual bleeding and spotting
- Mood changes
- Breast tenderness
- Bloating or fluid retention
- Nausea and vomiting
- Headache
On the other hand, less common but serious side effects that may occur as a result of taking HRT are:
- Sudden cough
- Breathlessness or difficulty breathing
- Severe chest pain, sometimes reaching the left arm
- Swelling in one leg or severe leg pain
- Weakness or numbness in any part of the body
- Speech changes, including slurring of words
- Vision changes, such as blurred or loss of vision
- Unexpected heavy or prolonged menstrual bleeding
- Dark urine
- Pale stools
- Abdominal pain
- Nausea and loss of appetite
- Yellowing of the skin or eyes (jaundice)
- Swelling of the face, eyes, lips or tongue
- Difficulty breathing
- Itchy rash spreading across the body
If you experience any of the above symptoms, see a doctor immediately to assess your condition.
Our Menopause Specialist
Dr Linsey Gani
Consultant Endocrinologist
MBBS (Aust), B Med Sci, FRACP (Endocrine), FAMS (S’pore), MPH (Harvard), Clinical Assistant Professor (Duke-NUS Medical School)
Languages: English, Mandarin, Bahasa Indonesia
Dr Gani is a menopause specialist trained in diagnosing and managing menopause-related concerns. She completed her residency training at the Austin and Repatriation Hospital and Monash Medical Centre in Melbourne.
Why Choose Us?
At LG Endocrinology, we provide expert guidance on HRT/MHT tailored to your symptoms, health goals, and long-term well-being, helping you manage menopause effectively.
Beyond medical expertise, Dr Gani provides care with empathy and understanding. She takes the time to listen, recognise your individual needs, and guide you through treatment with compassion at every stage.
Dr Linsey Gani is an experienced endocrinologist trained in managing menopause and hormone replacement therapy. Her expertise includes conditions related to hormonal changes, symptom management, and long-term health.
FAQs About Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)
What is the difference between perimenopause and menopause?
Perimenopause is the transitional phase leading up to menopause, during which estrogen levels fluctuate. The early phase of perimenopause can be variable, while the late phase of perimenopause can last 1–3 years. This period may bring a variety of symptoms, including irregular periods, hot flashes, mood swings, breast tenderness, fatigue, and reduced sex drive.
Conversely, menopause is diagnosed after 12 consecutive months without menstruation and marks the official end of reproductive life due to very low estrogen levels. Symptoms can include hot flashes, night sweats, mood changes, insomnia, vaginal dryness, and fatigue. Unlike perimenopause, menopause is a definitive stage rather than a transition, with consistently low hormone levels and the permanent cessation of periods.
Who is a suitable candidate for Hormone Replacement Therapy (HRT)/Menopausal Hormone Therapy (MHT)?
HRT/MHT may be suitable for individuals who are experiencing bothersome menopause symptoms, such as hot flashes, night sweats, vaginal dryness, mood changes, or sleep disturbances that interfere with daily life or well-being. It can also be considered for those at risk of osteoporosis, as HRT helps prevent bone loss and fractures after menopause.
Suitability depends on several factors, including age, health history, type and severity of symptoms, and personal risk factors for heart disease, stroke, blood clots, and certain cancers. Typically, HRT/MHT is most beneficial when started before age 60 or within 10 years of the onset of menopause. A healthcare professional can assess your situation, weigh the benefits against potential risks, and determine whether HRT/MHT is appropriate for you.
What are the alternatives to Hormone Replacement Therapy (HRT)/ Menopausal Hormone Therapy (MHT)?
For individuals who prefer not to take HRT, or for those for whom it may not be suitable, there are several other ways to manage menopause and perimenopause symptoms. The best approach depends on symptoms, personal preferences, and medical history.
- Tibolone and conjugated oestrogens with bazedoxifene (CEE/BZA) are also available options for women who experience menopausal symptoms
- Lifestyle adjustments: Ensuring a balanced diet, regular exercise, using stress-reduction techniques such as yoga or meditation regularly, and quitting smoking can ease symptoms and support long-term health.
- Supplements and non-hormonal treatments: Calcium and vitamin D help maintain bone strength, while herbal remedies like black cohosh or soy isoflavones may reduce hot flushes.
- Non-hormonal prescriptions: Options such as SSRIs for mood, Fezolinetant (neurokinin-3-receptor antagonist – works by targeting brain pathways linked to temperature control), and moisturisers for vaginal dryness can effectively target specific symptoms.
- Behavioural and complementary therapies: Cognitive-behavioural therapy and counselling may offer additional emotional and physical relief.
By combining these strategies, many individuals can achieve meaningful symptom relief without relying on HRT.
Disclaimer
This information is provided for general education. It does not replace personalised medical advice. Please consult your doctor for guidance on the medications that may be appropriate for you.
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Dr. Linsey Gani Endocrinology
10 Sinaran Drive, #10-08, Novena Medical Center, Singapore 307506
+65 6397 7101
+65 9128 7480
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Monday - Friday
08:30 - 12:30
14:00 - 17:30
09:00 - 12:00
Closed