# Hormone therapy (HRT): guides and answers · Unpaused > Source: https://unpaused.cc/topics/hrt ## Hormone therapy (HRT) What hormone replacement therapy does, the forms it comes in and how to weigh its benefits against its risks. 5 guides * [Perimenopause](/topics/perimenopause) * [Symptoms](/topics/symptoms) * [Hot flashes](/topics/hot-flashes) * [Sleep](/topics/sleep) * [Weight and diet](/topics/weight-and-diet) ### Guides on this topic [ ](/articles/menopause-weight-gain) #### [Menopause weight gain and belly fat ](/articles/menopause-weight-gain) Weight gain in perimenopause and menopause is common, often at the waist. Menopause and HRT have not been shown to be the main cause of the extra pounds. 18 Oct 2026 [ ](/articles/bioidentical-hormone-replacement-therapy) #### [Bioidentical hormone replacement therapy ](/articles/bioidentical-hormone-replacement-therapy) Bioidentical means the hormone molecule matches one the body makes. NHS body-identical HRT is a regulated medicine. Compounded mixes are not shown to be safer. 17 Oct 2026 [ ](/articles/will-hormone-replacement-therapy-cause-weight-gain) #### [Does HRT cause weight gain? What the trials show ](/articles/will-hormone-replacement-therapy-cause-weight-gain) HRT does not cause weight gain, according to a Cochrane review of 28 trials. Early bloating and fluid retention can feel like weight gain, and both usually settle. 17 Oct 2026 [ ](/articles/hrt-risks-in-plain-numbers-breast-cancer-clots-and-stroke-per-1-000-women) #### [HRT risks in plain numbers: extra cases per 1,000 ](/articles/hrt-risks-in-plain-numbers-breast-cancer-clots-and-stroke-per-1-000-women) Extra cases of breast cancer, blood clots and stroke per 1,000 women on hormone replacement therapy, by type, route and how long it is used. 17 Oct 2026 [ ](/articles/menopause-symptom-checklist-to-print-and-take-to-your-gp) #### [Menopause symptom checklist for your GP ](/articles/menopause-symptom-checklist-to-print-and-take-to-your-gp) A printable list of perimenopause and menopause symptoms, with how often each occurs and how much it bothers you, for a GP visit about hormone therapy. 17 Oct 2026 ### 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](https://www.nhs.uk/medicines/hormone-replacement-therapy-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](https://www.nice.org.uk/news/articles/updated-guideline-recommends-more-treatment-choices-for-menopause-symptoms)). 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](//pubmed.ncbi.nlm.nih.gov/35797481/)). ### What the guides here cover The articles in this topic go through the forms of HRT, [body-identical HRT and compounded bioidentical products](/articles/bioidentical-hormone-replacement-therapy), 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](/articles/will-hormone-replacement-therapy-cause-weight-gain). Counted risks for licensed therapy are in [HRT risks in plain numbers](/articles/hrt-risks-in-plain-numbers-breast-cancer-clots-and-stroke-per-1-000-women). Before that conversation, the [symptom checklist](/articles/menopause-symptom-checklist-to-print-and-take-to-your-gp) 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. ### Questions readers ask Is HRT safe? For most healthy women under 60 with symptoms, major guidelines say the benefits outweigh the risks. Your own history decides it, so it is a conversation for your doctor. What forms does HRT come in? Patches, gels, sprays and tablets for oestrogen, with the womb-protecting hormone given as a tablet or a coil, plus vaginal creams, pessaries and rings for local symptoms. Does HRT prevent heart disease or dementia? NICE says it should not be started for that purpose. It is prescribed for symptoms, and it also protects bone. ### Other topics * [Perimenopause: Perimenopause symptoms and the first signs, how long the stage lasts, and hormone replacement therapy while periods continue.](/topics/perimenopause) * [Symptoms: Brain fog, anxiety, aches and other changes, and what each symptom usually means.](/topics/symptoms) * [Hot flashes: Why the heat comes on, and which treatments have trial evidence, with and without hormones.](/topics/hot-flashes) * [Sleep: Why sleep breaks down in perimenopause and menopause, from sweating at night to 3am waking, and what helps you stay asleep.](/topics/sleep) * [Weight and diet: Why weight changes in midlife, and how to eat for energy, bone strength and heart health.](/topics/weight-and-diet) [See all topics on one page](/topics) --- Plain, practical menopause advice Plain, practical guides to perimenopause and menopause: symptoms, hormone therapy, sleep, hot flashes, weight and food, each checked against health services and medical societies. [desk@unpaused.cc](mailto:desk@unpaused.cc) ### Topics * [Perimenopause](/topics/perimenopause) * [Symptoms](/topics/symptoms) * [Hormone therapy (HRT)](/topics/hrt) * [Hot flashes](/topics/hot-flashes) * [Sleep](/topics/sleep) * [Weight and diet](/topics/weight-and-diet) * [All guides](/articles) ### About us * [About](/about) * [Authors](/authors) * [Editorial policy](/editorial-policy) * [How we make money](/how-we-make-money) ### Legal * [Terms](/terms) * [Privacy](/privacy) * [Contact](/contact) Unpaused © 2026 Unpaused. General health information, written from sources we link. It does not replace advice from your own doctor, nurse or pharmacist. [How we make money](/how-we-make-money) [Editorial policy](/editorial-policy) [Who writes here](/authors)