Hormone therapy can significantly relieve menopausal symptoms such as hot flushes, night sweats, sleep disturbances, mood changes, and vaginal dryness. In the longer term, it also helps protect against osteoporosis and, when started early, may have a beneficial effect on cardiovascular health.

The balance between benefits and risks is different for every woman. Your age, the timing of treatment, your personal and family medical history, and the type of hormones prescribed all play a role. Large, high-quality studies have shown that hormone therapy is both safe and effective for most healthy women under the age of 60, or within ten years of the onset of menopause.

At POMME Clinics, we carefully assess your individual health profile before recommending the most appropriate treatment plan.

This is the question we hear most often—and understandably so. The answer requires some nuance.

For women who have had a hysterectomy and use oestrogen-only therapy, current evidence does not show an increased risk of breast cancer. In fact, some studies suggest there may even be a slight reduction in risk.

For women who still have a uterus, progesterone is required to protect the uterine lining. The type of progesterone matters. Older synthetic progestogens have been associated in some studies with a small increase in breast cancer risk after prolonged use.

Micronised bioidentical progesterone, such as Utrogestan®, has demonstrated a more favourable safety profile in recent research, including the large French E3N study. It is therefore considered the preferred option in current clinical guidelines.

To put the potential risk into perspective, the small increase in breast cancer risk associated with combined hormone therapy after several years of use is comparable to the increased risk associated with drinking one alcoholic beverage daily or being overweight. Your individual risk depends on factors such as your family history, your age when treatment begins, and how long hormone therapy is used. These are all discussed in detail during your consultation.

Yes. The risk of cardiovascular disease increases after menopause. Before menopause, oestrogen helps protect the blood vessels and supports healthy cholesterol metabolism. As oestrogen levels decline, part of this natural protection is gradually lost.

When hormone therapy is started early—around the time menopause begins—it may reduce the risk of cardiovascular disease compared with women who do not receive hormonal treatment. This protective effect appears to be strongest with transdermal oestrogen, delivered through the skin via a patch, gel, or spray.

A healthy lifestyle remains essential alongside hormone therapy. Regular exercise, a balanced diet, avoiding smoking, and maintaining healthy blood pressure and cholesterol levels all play an important role in protecting your long-term heart health.

Yes. This is an important clinical distinction.

Transdermal oestrogen—delivered via a patch, gel, or spray—is absorbed directly into the bloodstream without first passing through the liver. As a result, the risk of developing blood clots (venous thromboembolism) is significantly lower than with oral oestrogen.

Oral oestrogen is processed by the liver, where it stimulates the production of certain clotting factors. For women with an increased risk of blood clots or a history of cardiovascular disease, transdermal oestrogen is generally the preferred option.

When prescribed at the appropriate dose, both forms are equally effective in relieving menopausal symptoms. However, most European clinical guidelines now recommend transdermal oestrogen as the first-line approach.

Bioidentical hormones have the exact same molecular structure as the hormones naturally produced by your body. Synthetic hormones act on the same receptors but have been chemically modified, meaning they are not structurally identical.

One of the most important differences is between micronised progesterone and older synthetic progestogens. Micronised bioidentical progesterone, such as Utrogestan®, has demonstrated a more favourable safety profile—particularly with regard to breast health and cardiovascular risk—than older synthetic alternatives.

At POMME Clinics, we prefer prescribing licensed bioidentical hormone therapies whenever possible, as their quality, consistency, safety, and effectiveness have been rigorously evaluated.

Femoston® is a combined hormone therapy containing both oestrogen and a progestogen in a single tablet.

Depending on your stage of menopause and treatment goals, it may be prescribed as:

Continuous combined therapy, where the same tablet is taken every day with the aim of eventually eliminating withdrawal bleeding.

Sequential therapy, where part of the cycle contains oestrogen only, followed by combined tablets, resulting in a monthly withdrawal bleed.

Utrogestan® contains micronised bioidentical progesterone only and is taken alongside a separate oestrogen preparation. This offers greater flexibility in both dosing and the choice of oestrogen formulation.

When taken at bedtime, Utrogestan® may also improve sleep quality and have a calming effect for some women.

The most suitable option depends on your symptoms, menstrual history, stage of menopause, and medical background.

Some women notice a mild improvement within a few days, but for most, significant symptom relief develops over the course of three to six weeks.

After approximately three months, it is usually possible to assess how well your body is responding and whether any adjustments to the dose or method of administration are needed.

Symptoms such as hot flushes and night sweats often improve relatively quickly. Improvements in joint and muscle discomfort, cognitive symptoms such as brain fog, and fatigue generally take longer and may require three to six months before meaningful changes become noticeable.

Patience is important, as many of the benefits of hormone therapy develop gradually.

Licensed hormone therapies available through regular pharmacies have undergone extensive testing for safety, effectiveness, and consistent absorption. Their composition is carefully regulated and approved by the relevant health authorities.

Compounded hormones are individually prepared by a specialised compounding pharmacy according to a prescription. This may be appropriate for women who are allergic to certain inactive ingredients or require a dosage that is not commercially available.

However, compounded preparations are regulated differently from licensed medicines, and their composition may vary slightly between batches.

At POMME Clinics, we recommend compounded hormones only when there is no suitable licensed alternative, and always through a certified compounding pharmacy.

Yes. Irregular or unexpected bleeding is common during the first three to six months after starting hormone therapy. In most cases, this is harmless and gradually settles as your body adapts to the treatment.

Do not adjust or stop your medication without consulting your clinician.

If the bleeding is very heavy, persists beyond six months, or becomes more frequent rather than improving, please discuss this during your follow-up appointment or contact your healthcare provider sooner.

Yes. It is common for the breasts to feel more tender, fuller, or slightly swollen during the first few weeks of hormone therapy. Some women also notice a temporary increase in breast volume.

This is a normal response to hormonal changes and usually settles on its own within a few weeks.

We generally recommend giving your body time to adjust before drawing conclusions about the treatment. If breast tenderness persists for longer than two months or becomes more severe, please discuss this with your clinician. In some cases, adjusting the dose or changing the type of progesterone may help.

Hormone therapy itself has not been shown to cause weight gain.

What many women experience is that menopause naturally changes metabolism and body composition, leading to increased fat storage around the abdomen and a gradual loss of muscle mass. These changes are often mistakenly attributed to hormone therapy.

During the first few weeks of treatment, some women may notice temporary fluid retention, which can cause a small increase on the scales or make rings feel tighter, particularly when taking Utrogestan®. This usually settles within a few months.

A diet rich in protein, adequate potassium intake, regular strength training, and good-quality sleep are among the most effective ways to support a healthy body composition during menopause.

For many women, yes. Oestrogen plays an important role in maintaining healthy joints, connective tissue, and muscle function. As oestrogen levels decline during menopause, joints may become stiffer and muscles may fatigue more easily.

Relief from muscle and joint symptoms tends to develop gradually. Most women notice meaningful improvement after three to six months of treatment.

Supporting hormone therapy with regular exercise, strength training, and, where appropriate, magnesium supplementation may provide additional benefits.

Yes. As oestrogen levels decline, collagen production decreases, causing the skin to become thinner, less elastic, and drier over time. Hair may also become finer or lose volume.

Hormone therapy may help slow these changes and can have a positive long-term effect on skin quality, hydration, and elasticity.

Lifestyle also plays an important role. A protein-rich diet, adequate antioxidant intake, consistent sun protection, and a personalised skincare routine all help support healthy skin throughout and after menopause.

No. Treatments provided at POMME Clinics are not reimbursed by standard or supplementary health insurance plans.

Vaginal dryness is one of the most common—and often underreported—symptoms of menopause.

As oestrogen levels decline, the vaginal tissues become thinner, less elastic, and produce less natural lubrication. This can lead to discomfort, pain during intercourse, and an increased susceptibility to urinary and vaginal infections.

Local vaginal oestrogen treatments—including creams, tablets, or vaginal rings—are highly effective. They act locally with minimal absorption into the bloodstream and are suitable even for women who do not use, or prefer not to use, systemic hormone therapy.

Non-hormonal vaginal moisturisers and lubricants can also provide significant symptom relief.

Bladder and urinary symptoms become more common during and after menopause.

As oestrogen levels fall, the tissues of the bladder and urethra also become thinner and more fragile. This can result in burning sensations, increased urinary urgency, frequent urination, or recurrent urinary tract infections.

Local vaginal oestrogen therapy is a safe and effective treatment and can be used long term.

If urine leakage occurs when coughing, laughing, or exercising, pelvic floor weakness may also be contributing. In these cases, pelvic floor physiotherapy is often an excellent first step.

During your consultation, we will discuss which treatment approach is most appropriate for your individual symptoms.

A lower libido during menopause is usually caused by a combination of factors.

Physical symptoms such as vaginal dryness, pain during intercourse, fatigue, and poor sleep often contribute. Emotional wellbeing, stress, body image, and relationship factors can also play an important role.

Addressing the underlying causes—such as improving sleep quality, treating vaginal symptoms, or optimising hormone therapy—is often enough to improve sexual desire.

For some women, carefully prescribed testosterone therapy may also be considered as part of an individualised treatment plan. This is something you are welcome to discuss during your consultation.

Menopause places significant demands on the body.

Hot flushes that disrupt sleep, fluctuating hormone levels, and cognitive symptoms such as brain fog can all contribute to ongoing fatigue. In addition, many women are managing demanding careers, caring responsibilities, or other major life changes during this stage of life.

If your fatigue is persistent or significantly affecting your quality of life, it is important to discuss it with your clinician.

Sometimes other medical conditions contribute, including iron deficiency, low vitamin D, vitamin B12 deficiency, or thyroid disorders. A thorough assessment is the first step towards identifying the underlying cause and choosing the most appropriate treatment.

Nutrition, a protein-rich diet (at least 1.2 g per kg of body weight) helps preserve muscle mass, which naturally declines more rapidly during menopause. Adequate calcium and vitamin D are essential for bone health. An anti-inflammatory dietary pattern—rich in vegetables, oily fish, nuts, and olive oil—can help reduce low-grade chronic inflammation. Alcohol, even in small amounts, may worsen hot flushes and negatively affect sleep quality.

Exercise:
Strength training is the most effective intervention for preserving muscle mass, bone density, and metabolic health. This should be combined with cardiovascular exercise. The general recommendation is at least 150 minutes of moderate activity per week, ideally including two strength-training sessions.

Sleep & stress:

A consistent sleep routine, limiting screen exposure before bedtime, and practices such as breathwork or mindfulness have been shown to reduce the severity of menopausal symptoms.

Not always. Early symptoms are often subtle and variable.

In women not using hormonal contraception, changes in menstrual patterns—such as irregular cycles or longer intervals between periods—are often the first sign. Other early symptoms may include hot flushes, sleep disturbances, mood changes, or reduced energy, sometimes years before menstruation stops completely.

Menopause is primarily a clinical diagnosis based on symptoms and menstrual history. Blood tests are not always necessary, but may be useful in younger women, when the diagnosis is unclear, or to assess response to hormone therapy.

The age at which menopause begins often has a genetic component, and may be similar to that of your mother. However, the type and severity of symptoms cannot be predicted based on family history.

Every woman experiences menopause differently.

While taking the combined oral contraceptive pill, hormone levels remain artificially stabilised. As a result, menopausal symptoms may be masked or less noticeable.

However, during the pill-free interval, symptoms such as hot flushes or night sweats may still occur, revealing an underlying menopausal transition.

If it becomes clear that you are in menopause, the contraceptive pill is usually not the most appropriate treatment for symptom management. In such cases, we can discuss alternative therapies better suited to your needs.

Current clinical guidelines state that hormone therapy can be continued for as long as the benefits outweigh the risks for the individual patient. This should be reviewed annually.

Ongoing monitoring typically includes yearly consultations, blood pressure checks, and review of any new symptoms or health changes. Routine preventive care, such as mammography and gynaecological screening, remains essential.

Some women choose to stop treatment after a few years, while others—particularly those with early menopause or increased risk of osteoporosis—may benefit from longer-term use.

At POMME Clinics, we provide continuous follow-up and adjust your treatment plan according to your evolving needs.