Guides · Hormone therapy
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.
Where the fear came from
The Women’s Health Initiative, a large NIH-funded study, reported increased risks with certain hormone regimens in 2002, and HT use dropped sharply afterward.3 Later analyses looked closely at age and timing, which changed how experts interpret the results.1
What The Menopause Society says now
Its 2022 position statement says hormone therapy is the most effective treatment for hot flashes and night sweats and for genitourinary 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 Starting later, at older ages, carries greater risks.1
Forms matter
- If you have a uterus, estrogen is generally paired with a progestogen to protect the uterine lining.2
- Low-dose vaginal estrogen treats vaginal and urinary symptoms and is a different thing from systemic therapy.12
- Pills, patches, gels and sprays carry different risk profiles, so ask about the options.1
Not right for everyone
A history of certain cancers, blood clots, stroke or liver disease can make HT unsuitable. That’s exactly why this is a conversation with your clinician, not a decision a website can make.12 Non-hormone options exist too.
Questions to bring
- Given my health history, am I a candidate?
- Which form and dose would you suggest, and why?
- How will we review whether it’s working, and when?
Sources
- The Menopause Society. The 2022 hormone therapy position statement. Menopause, 2022. pubmed.ncbi.nlm.nih.gov
- ACOG. Hormone Therapy for Menopause (FAQ). www.acog.org
- NHLBI (NIH). Women’s Health Initiative. www.nhlbi.nih.gov
Information for better conversations, not a diagnosis. We’re not clinicians; we read the research and show our sources. See our disclaimer.