The best type of HRT for you will depend on your symptoms, medical history, and background risk factors for your age. Dr Arif recommends the newer bioidentical hormones – sometimes called body identical hormones – which are made from yams and other plants, as they are the closest to those produced naturally by the body. “These can be delivered through the skin and are the safest way to take HRT,” said Dr Arif. “The NICE Menopause Guideline has said bio identical HRT does not raise the risk of breast cancer or heart diseases if given through the skin.”

Dr Arif prefers to prescribe gels like Oestrogel or Sandrena, or the spray Lenzetto, “as it gives women more flexibility to control their symptoms than patches do. But I also prescribe patches and the oral version. Although the risks with the oral pill are slightly higher, they are still small.” 

Mr Haitham Hamoda, a consultant gynaecologist, clinical lead of London’s King’s College Hospital menopause service and chairman of the British Menopause Society, says bioidentical hormones are safest when administered through the skin. “Then there is no added risk of blood clots or stroke.” 

Women can be prescribed bioidentical forms of both oestrogen and progesterone on the NHS, so if you decide this is the type of HRT you want, make sure you are specific when you have your GP consultation and mention the NICE Menopause Guideline.