Ask Marily – Star Question: Coming off HRT

Q: I am 56 years old and have been on HRT for nearly six years now and I would like to come off it, what is the best way to do this?  Also can eating phytoestrogens be used to help me come off HRT?


A: The question I am most asked is ‘should I just stop HRT or should I come off it gradually’? You should talk to your doctor about your decision to come off HRT and have any check ups that might be needed. My recommendation is always that a gradual weaning process is actually going to be easier on your body. Stopping HRT suddenly is similar to going ‘cold turkey’ and there have been reports of ‘rebound’ effects from the quick withdrawal of the hormones. The rebound effects can actually give tremendous hot flushes and seemingly worsened menopausal symptoms. 


It is better to take three months to gradually wean yourself off HRT. Ask your doctor for a lower dose and if you cannot reduce the dose of the HRT, you could switch to a patch. Because the patch delivers oestrogen through the skin and does not have to be broken down by the liver first, you can get by with a lower dose than if it is taken by mouth. Alternatively, you could use an oestrogen gel, rubbing in smaller amounts of oestrogen each time. Remember, though, that the dose of the progestogen must not be altered if you are on a type of HRT that stimulates a withdrawal bleed. It is important that this happens each month until you come off HRT entirely. 


During that three month weaning process, you would then start to introduce phytoestrogens (like soya, chickpeas, linseeds etc) into your diet so that when you stop the HRT you are cushioned by plant oestrogens already circulating in your system and any effects from stopping the HRT should be minimal. If you need extra help then you can use herbs like black cohosh (see Black Cohosh Plus on Resources page). For more information on the menopause see my book ‘The New Natural Alternatives to HRT’.

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