Hormone Replacement Therapy (HRT) Singapore
Key Takeaways
- HRT replaces oestrogen around menopause, or testosterone in men with low levels, to ease symptoms
- It comes as tablets, gels, patches, injections or vaginal treatments
- Side effects such as breast tenderness and headaches often ease within the first few months
- Combined HRT slightly raises the risk of breast cancer
Medically Reviewed By: Dr Jana Lim, Board-Accredited Family Physician
Board-Accredited Family Physician | MBChB, MMed (FM)
MBChB, MMed (FM) | Last updated:
What Is Hormone Replacement Therapy (HRT)?
Hormone replacement therapy (HRT) is a prescription treatment that replaces hormones your body no longer makes enough of. In women, this is usually oestrogen, which falls during menopause. In men, it is testosterone, when blood tests confirm a low level.
HRT for women is also known as menopausal hormone therapy (MHT), and HRT for men as testosterone replacement therapy (TRT). Both aim to bring hormone levels back to a normal range, which can ease the symptoms that low levels cause.
How Does HRT Work?
HRT works by giving your body hormones that act in the same way as your own. These hormones help control body temperature, mood, energy, sex drive and bone strength, so replacing them can ease symptoms linked to each.
HRT comes in several forms:
- Tablets – swallowed and processed by the liver before entering the bloodstream
- Gels and patches – absorbed steadily through the skin
- Injections – release the hormone slowly over several weeks
- Vaginal tablets or creams – act mainly in and around the vagina
The dose is usually the lowest that controls your symptoms, and it is reviewed regularly.
What Are the Benefits of HRT?
The main benefit of HRT is relief from symptoms caused by low hormone levels. HRT may help with:
- Menopause symptoms – hot flushes, night sweats, poor sleep, mood changes and vaginal dryness often ease within a few days or weeks
- Low testosterone symptoms – tiredness, low sex drive, erection problems and loss of muscle may improve as testosterone returns to a normal range
Can HRT Help Prevent Osteoporosis?
HRT helps to prevent osteoporosis, a condition in which bones become thin and break more easily. Oestrogen slows the rate at which bone is broken down, so bone loss speeds up once oestrogen falls after menopause. In men with low testosterone, TRT may also help maintain bone strength.
HRT is particularly important if your periods stopped before the age of 45, as your bones would otherwise go without oestrogen for longer. A DEXA scan can measure your bone density, to check whether your bones are already thinning.
Signs You May Need HRT
You may benefit from HRT if symptoms of low hormone levels are affecting your daily life. Signs include:
- Menopause symptoms – hot flushes or night sweats that wake you up, low mood or irritability, trouble sleeping, or vaginal dryness and pain during sex
- Early or surgical menopause – periods that stop before the age of 40 (premature ovarian insufficiency), or menopause after surgery to remove both ovaries
- Low testosterone symptoms in men – tiredness, low sex drive, erection problems or loss of muscle, with a low level confirmed on a blood test
These symptoms can also have other causes, such as thyroid problems or stress, so a medical assessment comes first. For women, HRT can be taken during perimenopause (the years leading up to menopause), so you do not need to wait until your periods have stopped.
Types of HRT
HRT is grouped by the hormone it replaces: oestrogen for women around menopause, and testosterone for men with low levels.
Menopausal Hormone Therapy (MHT)
MHT replaces oestrogen. If you have not had a hysterectomy (an operation to remove the womb), oestrogen is usually combined with a progestogen (a hormone similar to progesterone). The progestogen keeps the womb lining from thickening, which lowers the risk of womb cancer.
Oestrogen-only MHT is used after a hysterectomy. Vaginal oestrogen treats dryness and discomfort in and around the vagina.
Testosterone Replacement Therapy (TRT)
TRT replaces testosterone in men whose blood tests confirm a low level. It is usually given as a long-acting injection or a gel applied to the skin each day. Regular checks of your testosterone level, red blood cell count and prostate health are part of TRT, as testosterone can affect both your blood and your prostate.
Bioidentical HRT
Bioidentical hormones are chemically identical to those your body makes. They may be used in MHT or TRT, with the same assessment and monitoring as other HRT.
Unsure whether HRT is suitable for you? Book a consultation, and our male and female doctors can review your symptoms and medical history and talk you through your options.
WhatsApp UsWhat Are the Potential Side Effects of HRT?
Side effects of HRT are usually mild and often ease within the first few months as your body adjusts. They depend on the hormone, dose and form, and may include:
- Breast tenderness, mainly with oestrogen
- Nausea, headaches or bloating, especially when starting tablets
- Mood changes in the first few weeks
- Skin irritation where patches or gels are applied
- Acne or oily skin with testosterone
- Spotting or irregular vaginal bleeding with MHT, which usually stops within 6 months
Less common but more serious risks include blood clots and stroke, mainly with HRT tablets, and certain hormone-sensitive cancers with MHT.
TRT can raise the red blood cell count and may worsen sleep apnoea (pauses in breathing during sleep). Your reviews check for these, so the dose or form can be changed if needed.
Does HRT Increase the Risk of Breast Cancer?
Combined HRT slightly increases the risk of breast cancer. Taking it for 5 years from around age 50 adds about 1 extra case in every 50 to 70 women by age 69, compared with about 1 in 200 for oestrogen-only HRT. The risk rises the longer you take it and falls after you stop, although some extra risk can last for years after long-term use. Vaginal oestrogen does not raise the risk.
Keep up with regular breast screening, such as a mammogram, while you take HRT. If you are worried about breast cancer, a doctor can help you weigh the risks and benefits of HRT based on your age, health and family history.
Disclaimer: This is not a complete list of side effects. The information here does not replace professional medical advice, so discuss any concerns about side effects with your doctor.
Is HRT Suitable for Everyone?
HRT is usually not recommended if you have a condition that hormones could make worse, such as:
- A history of breast, prostate, womb or ovarian cancer
- A history of stroke or heart disease
- Current or past blood clots, such as deep vein thrombosis (DVT) or a clot in the lungs (pulmonary embolism)
- Vaginal bleeding that has not been checked by a doctor
- Untreated severe sleep apnoea or uncontrolled heart failure, for TRT
- High blood pressure that is not yet under control
- Liver disease
Some of these conditions do not rule out every form of HRT. Patches or gels may still be an option if you have had blood clots, as they do not raise the clot risk the way tablets can.
How to Get HRT in Singapore
In Singapore, HRT needs a doctor's prescription. The process usually involves:
- Consultation – your symptoms, medical history, family history and current medicines are reviewed to check whether HRT is suitable for you.
- Tests – for men, a blood test measures testosterone, sometimes alongside related markers. For women, hormone blood tests may be done to confirm menopause if you are under 45 or the cause of your symptoms is unclear.
- Treatment plan – if HRT is suitable, you are prescribed a type, dose and form based on your symptoms and health, with guidance on what to expect.
- Follow-up – reviews usually take place within the first few months, then regularly, with dose changes and repeat tests where needed.
"Falling hormone levels, whether at menopause or with low testosterone, can affect your sleep, mood, energy and sex drive. You do not need to put up with these changes, as HRT and other treatments can ease them when they are suitable for you."
Dr Jana Lim
What Is the Cost of HRT in Singapore?
At Singapore Women's Clinic, we provide HRT for women and men, and non-hormonal menopause treatments, after a consultation with our doctors. Our prices are as follows:
| Treatment / Test | Price* |
|---|---|
| Consultation | $65.40 |
| Extended Consultation (Over 30 Minutes) | $98.10 |
| Menopausal Hormone Therapy | |
| Systemic MHT (Oral Tablets), Tibolone | $75.21 |
| Systemic MHT (Oral Tablets), Progesterone | $43.60 |
| Systemic MHT (Transdermal Oestrogen Gel) | $35.97 |
| Local Vaginal Oestrogen Therapy (Vaginal Tablet) | $70.85 |
| Non-Hormonal Options (for Menopause Management) | |
| Prescription Medication (Oral Tablets): Fezolinetant (Veoza) | $136.85 |
| Supplement (Oral Capsules): Soy Isoflavones | $68.67 |
| Local Vaginal Moisturiser (Vaginal Pessary): Gynella Balance | $65.40 |
| Testosterone Replacement Therapy | |
| Testosterone Injection | $381.50 / injection |
| Testosterone Gel | $196.20 / box |
| Hormone Testing | |
| Estradiol / Oestrogen (E2) | $32.70 |
| Follicle Stimulating Hormone (FSH) | $32.70 |
| Thyroid Function Test (TSH) | $32.70 |
| Vitamin D Deficiency Test | $130.80 |
| DEXA Bone Densitometry | $141.70 |
|
Female Acne / Weight Gain Screen**
Testosterone, Estradiol, Progesterone, TSH, Cortisol, FSH, Luteinising Hormone (LH), Prolactin, Dehydroepiandrosterone Sulfate (DHEAS), Sex Hormone Binding Globulin (SHBG). May be recommended for those suspected of having hormonal acne.
Testosterone, Estradiol, Progesterone, TSH, Cortisol, FSH, Luteinising Hormone (LH), Prolactin, Dehydroepiandrosterone Sulfate (DHEAS), Sex Hormone Binding Globulin (SHBG). May be recommended for those suspected of having hormonal acne.
|
$218 |
|
Hormonal Study
DHEAS, Insulin-like Growth Factor 1 (IGF-1), SHBG, FSH, LH, E2
DHEAS, Insulin-like Growth Factor 1 (IGF-1), SHBG, FSH, LH, E2
|
$196.20 |
|
Comprehensive Deficiency / Hair Loss Screen
Folate, Vitamin B12, Vitamin D, Iron, Total Iron Binding Capacity, % Iron Saturation, Ferritin, Zinc, Magnesium, Free T4, TSH
Folate, Vitamin B12, Vitamin D, Iron, Total Iron Binding Capacity, % Iron Saturation, Ferritin, Zinc, Magnesium, Free T4, TSH
|
$263.78 |
| Women's Wellness (Full Body Screening) | From $152 |
*All prices are NETT and inclusive of GST.
**Recommended to be done during days 2 to 5 of the menstrual cycle, between 8.30am and 10am, for accuracy.
Payment Options We Accept
For your comfort, consultations are available with our male or female doctors, so let us know your preference when you book.
If you would like a broader check at the same visit, our doctors can recommend a health screening package with the relevant blood tests.
Meet Our Doctors
Dr Jana Lim has completed the International Menopause Society (IMS) IMPART Programme (Level 1), a structured training programme in menopause care and menopausal hormone therapy.
