Hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT), is one of the most effective treatments available for hot flashes, night sweats, sleep disturbances, and other symptoms related to menopause. For many women, hormone therapy can also improve quality of life, sexual health, and overall well-being.
Despite its benefits, hormone therapy is often misunderstood. Many women have questions about safety, breast cancer risk, blood clots, heart disease, bioidentical hormones, hormone pellets, and whether treatment is appropriate for them. Recommendations regarding hormone therapy have evolved significantly over time as new research has become available.
Potential benefits of hormone therapy may include:
• Reduction in hot flashes and night sweats
• Improved sleep quality
• Improved vaginal and urinary symptoms
• Improved sexual comfort and quality of life
• Prevention of bone loss and osteoporosis
• Improvement in some menopause-related quality-of-life symptoms
Hormone therapy is not appropriate for everyone, and treatment decisions should be individualized based on symptoms, medical history, age, and personal preferences.
The resources below provide information about the benefits, risks, safety, and treatment options available for menopausal hormone therapy.
Hormone therapy is not a single medication. Treatment can be individualized based on symptoms, medical history, personal preferences, and whether a woman still has a uterus. Common options include:
Systemic Estrogen: Systemic estrogen circulates throughout the body and is commonly used to treat hot flashes, night sweats, sleep disturbances, and other menopause symptoms.
Oral estrogen pills
Transdermal estrogen patches
Estrogen gels, sprays, or vaginal ring
Progesterone: Women who still have a uterus typically require progesterone along with systemic estrogen to protect the uterine lining.
Oral micronized progesterone
Synthetic progestins, Mirena IUD
Combined Hormone Therapy: Some products contain both estrogen and progesterone in a single medication.
Combination pills
Combination patches
Vaginal Estrogen: These treatments primarily target vaginal dryness, discomfort with intercourse, urinary symptoms, and other symptoms of genitourinary syndrome of menopause (GSM).
Vaginal creams
Vaginal tablets
Vaginal inserts/rings
Other Hormonal Therapies: These options may be appropriate in certain situations and should be discussed with your healthcare provider.
Testosterone therapy
Many women are interested in "bioidentical" hormone therapy. The term bioidentical refers to hormones that have the same chemical structure as the hormones naturally produced by the body.
It is important to understand that many FDA-approved hormone therapy products contain bioidentical hormones, including several forms of estradiol and micronized progesterone. These products are manufactured under strict quality and safety standards and have been studied extensively.
Some bioidentical hormone products are prepared by compounding pharmacies. While compounded hormones may be appropriate in select situations, they are generally not recommended over FDA-approved products when an approved option is available, as compounded products are not subject to the same FDA oversight for consistency, purity, effectiveness, and safety.