Many women are afraid of HRT because of headlines from the early 2000s. Since then, researchers have re-examined the data, and current international menopause guidelines take a far more balanced view.
Who benefits most
For healthy women under 60, or within 10 years of their last period, the benefits of HRT usually outweigh the risks. HRT is the most effective treatment for hot flushes and night sweats. It also helps sleep and vaginal dryness and protects bones from osteoporosis.
Understanding the risks
- Breast cancer: combined HRT (estrogen plus progesterone) is linked with a small increase in risk, which rises with longer use. Estrogen-only HRT, for women without a womb, shows little or no increase. Lifestyle factors such as alcohol and excess weight carry a risk of a similar size.
- Blood clots: HRT tablets slightly increase the risk of clots. Estrogen through the skin, as a patch or gel, does not appear to.
- Stroke and heart: the risk depends on age and type. Starting HRT close to menopause appears safer than starting it many years later.
Who should be careful
Women with a past history of breast cancer, unexplained vaginal bleeding, previous blood clots or active liver disease need a specialist assessment. Other treatments may suit them better.
The bottom line
HRT is not right or wrong for everyone. The decision depends on your symptoms, age, time since menopause, personal and family history, and your preferences. It should be reviewed every year with your doctor.
This article is general information and not a substitute for a medical consultation.