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Hormone therapy: what the current research says

Few topics cause more confusion. Many of us remember the early-2000s headlines and assumed hormone therapy (HT, often called HRT) was off the table. The picture today is more nuanced.

2 min readUpdated Oct 2026Evidence-checked · sources listed

Information for better conversations, not a diagnosis. This is research with sources, not medical advice. Talk to your clinician about your situation.

Where the fear came from

The Women’s Health Initiative, a large NIH-funded study, found that estrogen plus progestin after menopause raised the risk of heart disease, stroke, blood clots, breast cancer and dementia, according to the NIH’s National Heart, Lung, and Blood Institute. The NHLBI also says hormone therapy “is still an option for some women early in menopause to help relieve moderate to severe symptoms.”3 The Menopause Society’s 2022 statement says the risks differ depending on type, dose, duration of use, route, timing of starting, and whether a progestogen is used.1

What The Menopause Society says now

Its 2022 position statement says hormone therapy “remains the most effective treatment” for hot flashes and night sweats and for genitourinary (vaginal and urinary) symptoms. For healthy women under 60, or within 10 years of menopause, who don’t have contraindications, it describes the benefit-risk ratio as favorable.1 For women who start later, at older ages, it says the benefit-risk ratio appears less favorable.1

Forms matter

  • ACOG says that if you still have a uterus, you also need a progestin, which helps reduce the risk of uterine cancer that can occur when estrogen is used alone.2
  • ACOG describes two kinds: systemic estrogen (pills, skin patches, gels and sprays), which travels through the bloodstream, and local estrogen (a vaginal ring, tablet or cream) for women who only have vaginal dryness.2
  • The Menopause Society notes that route of administration is one of the factors that affects risk, so it’s worth asking about the options.1

Not right for everyone

ACOG says systemic hormone therapy usually is not recommended if you have ever had breast or endometrial cancer, a stroke, a heart attack, blood clots or liver disease.2 That’s why this is a conversation with your clinician, not a decision a website can make. The Menopause Society’s 2023 statement also recommends several non-hormone options.4

Questions to bring

  • Given my health history, am I a candidate?
  • Which type would you suggest for me, and why?
  • How will we review whether it’s working, and when?

Sources

  1. The Menopause Society. The 2022 hormone therapy position statement. Menopause, 2022. pubmed.ncbi.nlm.nih.gov
  2. ACOG. Hormone Therapy for Menopause (FAQ). www.acog.org
  3. NHLBI (NIH). Women’s Health Initiative. www.nhlbi.nih.gov
  4. The Menopause Society. The 2023 nonhormone therapy position statement. Menopause, 2023. pubmed.ncbi.nlm.nih.gov

Information for better conversations, not a diagnosis. We’re not clinicians; we read the research and show our sources. See our disclaimer.