Hormone therapy (HRT)

Hormone therapy (HRT): the overview

Hormone replacement therapy (HRT, called MHT or hormone therapy in the US) replaces the oestrogen your ovaries stop making. If you still have a womb, it is paired with a progestogen to protect the womb lining. Oestrogen can be taken as a patch, gel, spray or tablet, and there are low-dose vaginal forms for dryness and urinary symptoms (the NHS guide to HRT).

What the guidelines say

NICE's 2024 update calls HRT the most effective treatment for hot flushes and night sweats, and finds it unlikely to change overall life expectancy. It also says HRT should not be started to prevent heart disease or dementia (NICE, November 2024).

The Menopause Society's 2022 position statement reaches a similar place: for healthy women with symptoms who are under 60, or within ten years of their last period, the benefits generally outweigh the risks. Started later, the balance is less favourable. Risk depends on the type, the dose, how it is taken, for how long, and whether progestogen is part of the prescription (Menopause, 2022).

What the guides here cover

The articles in this topic go through the forms of HRT, body-identical HRT and compounded bioidentical products, breast cancer and blood clot risk in plain numbers, side effects, how long it takes to work, and how to ask for it. One worry that stops many women starting is whether HRT causes weight gain. Counted risks for licensed therapy are in HRT risks in plain numbers.

Before that conversation, the symptom checklist is a way to show which symptoms are bothering you, and how often.

Ines Kovac's view: go into the appointment with your own risk factors written down (family history, migraines with aura, past clots, smoking). The decision turns on those far more than on headlines.

Written by the Unpaused editors. Updated 2026-10-17.