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Hormone replacement treatment

Hormone replacement therapy should be considered by post menopausal women with kidney failure, and also by younger women who do not have periods, or have very irregular periods. Research has shown that women with kidney failure do not often receive hormone replacement. The reasons for this are not clear.

Women should discuss the advantages and disadvantages of treatment in their own case with their own kidney doctors and nurses.


Will someone on hormone replacement therapy feel better?  Normally hot flushes will go away and there has been very little research on this in kidney failure, but one study did report an increase in well being and sex drive.

Post menopausal women are at increased risk of heart problems and osteoporosis and it would seem likely at first sight that carrying on with oestrogen hormones after the meonpause would reduce the development of these problems. Unfortunately, the data from clinical trials is not yet conclusive.  It may be that starting HRT soon after menopause has some delaying effects on bone and heart disease and women taking HRT seem slightly less likely to die prematurely.  However, these data have not been proven in women with kidney disease and the benefits to the bones and the heart may not happen if HRT is started a long time after the menopause.


Hormone replacement therapy causes menstrual bleeding to occur.  There are also side effects of hormone replacement therapy that may occur in anyone, such as high blood pressure.

Also, some research has suggested that the dose of hormone replacement therapy needed by women may be affected by kidney failure or dialysis. The hormones in HRT can increase the risk of developing blood clots and this might be even more important in patients with kidney disease, especially if they are on dialysis, where higher haemoglobin levels have been shown to increase the risk of blood clots.  There may also be an increased risk of breast cancer.  A woman with kidney disease who is thinking of taking HRT should have a detailed discussion with their medical
team about the risks and benefits of the treatment.

6. Sex and dialysis treatment

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

NKF Controlled Document No. 206: Hormone replacement treatment written: 15/12/2002 last reviewed: 13/03/2019