• feelings of nausea

• breast tenderness

• feeling bloated before a period

• slight weight-gain

• disturbances of the digestive system

• leg cramps

• headaches

• feelings of pre-menstrual tension and other complaints caused by taking progestogen

Although this may seem a daunting list, most of these problems are quite short-lived for the majority of women on HRT.

Feelings of nausea. These usually wear off quite quickly, and are much less of a problem with the patch and implant than with tablets.

Breast tenderness. This, too, usually wears off after the first week or two. If it is troublesome, it may be relieved by starring with a low dose of oestrogen and building up once your body has become used to having the hormone again.

Feeling bloated. This is caused by fluid retention, and may include swollen ankles. Talk to your doctor about it; he may prescribe ‘water tablets’, or the symptoms may subside by themselves.

Disturbances of the digestive system (known as gastrointestinal disturbances). These are more common with oral HRT than with other types. If you take the oral form, these symptoms are often relieved by taking the tablet with food, or at bedtime; if this doesn’t help, a non-oral route like the patch or implant may solve the problem.

Leg cramps. Cramp, especially in the calves, sometimes occurs in the first few months of taking HRT. It may be worse at night, and usually disappears before long. If you regularly get cramp in one leg only, mention it to your GP, who will want to check that you are not at risk of developing a thrombosis.

Headaches. These are usually short-lived, too. If you developed migraine at the time of the menopause, HRT may relieve it; if the HRT causes headaches, they should pass, but if they don’t your doctor may suggest changing the dosage or type.

PMT and other symptoms of progestogen These have been covered in Chapter 3. Again, the patch form of progestogen may see the end of many of these troublesome complaints, so should the newer progestogens when they become available.

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