Understanding MHT (HRT) and Other Treatment Options

What you will be able to do

• explain the difference between combined and estrogen-only MHT, and why progestogen is added for people with a womb.
• describe the main forms of MHT and why tablets carry different risks from patches and gels.
• summarize the benefits and risks of MHT in the way Canadian menopause guidelines describe them.
• tell the difference between absolute and relative risk, and ask for your own risks as numbers.
• describe local options for vaginal and urinary symptoms, including what you can buy at a pharmacy without a prescription.
• outline non-hormonal options, including CBT, and what experts say about herbal and compounded products.
• prepare for and take part in a shared decision with your family doctor or pharmacist, and know what happens at reviews.

1. 1Why treatment options exist, and how menopause care works in Canada

   A short reminder of what changes around the menopause, then how health care providers in Canada approach treatment decisions, so you know who does what before you look at the options.

   • Menopause in brief: what treatment is trying to help
   • How decisions are made: guidelines, your health care provider and shared decision-making

   Questions for my family doctor or pharmacist

2. 2MHT explained: the hormones, the forms and the patterns

   What is in MHT, why some people need two hormones, the different ways it can be taken, and the terms you will hear in your appointment.

   • Estrogen and progestogen: why there are two types of MHT
   • Ways to take MHT: tablets, patches, gels and more
   • Cyclical or continuous: the patterns of combined MHT

   Menopause options comparison sheet (education only)

3. 3Benefits and risks, as Canadian menopause guidelines describe them

   What MHT can help with, how to make sense of risk numbers, and the specific risks and side effects health experts list.

   • What MHT can help with
   • Making sense of risk: absolute and relative numbers
   • The risks one by one, side effects and who may not be suited

   Questions for my family doctor or pharmacist

4. 4Vaginal and urinary symptoms: local options

   Why vaginal and bladder symptoms happen, the local treatments health experts describe, and what you can get from a pharmacy without a prescription.

   • Genitourinary symptoms: common, treatable and often not mentioned
   • Vaginal estrogen, moisturisers and lubricants

   Menopause options comparison sheet (education only)

5. 5Options besides MHT

   Talking therapy, non-hormonal medicines, herbal and 'natural' products, and everyday habits, described the way health experts describe them.

   • CBT: a talking therapy included in menopause guidelines
   • Non-hormonal prescription medicines
   • Herbal products, 'bioidentical' hormones and everyday habits

   Menopause options comparison sheet (education only)Myths vs evidence cards

6. 6Your family doctor or pharmacist conversation

   How to prepare, what to ask in the room, and what happens afterwards, including reviews, costs and how decisions about stopping are made.

   • Before the appointment: getting ready
   • In the room: questions that help you decide together
   • After the appointment: reviews, prescriptions and stopping

   Questions for my family doctor or pharmacist

7. 7Myths, evidence and trustworthy information

   Common myths about menopause treatment, how to judge what you read and see online, and your next steps.

   • Common myths, and what the evidence says
   • Judging what you read, and your next steps

   Myths vs evidence cardsMenopause options comparison sheet (education only)

• ListMenopause options comparison sheet (education only)Side-by-side summaries of the main treatment options Canadian menopause guidelines describe, with space to add your own notes and questions before you see your family doctor or pharmacist.
• TemplateQuestions for my family doctor or pharmacistA one-page prep sheet so you can explain how symptoms affect you, share the history a prescriber needs, and ask the questions that matter to you.
• CardsMyths vs evidence cardsPocket cards that set common menopause treatment myths against what Canadian menopause guidelines and health experts actually say, to help you sort fact from fear before a conversation with your family doctor.