Table of ContentsView AllTable of ContentsTypesBenefitsRisksWhat to ExpectFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Types

Benefits

Risks

What to Expect

Frequently Asked Questions

Hormone replacement therapy (HRT) is a treatment that can help ease some of thesymptoms associated with menopause—the point in time when a person’smenstrual cyclehas stopped for 12 straight months and permanently ends. During the transition into menopause, the body gradually makes less of the hormonesestrogenandprogesterone, causing bothersome symptoms like night sweats,hot flashes, andvaginal dryness.

For many healthy adults, replacing these levels of hormones in the body through HRT can provide relief during the menopausal phase. HRT is prescribed with caution, as risks may include an increased chance of developing serious conditions likebreast cancerandheart diseasein certain people.

This article discusses the different types of HRT available for treating menopause symptoms and outlines the potential benefits and risks.

Anchiy / Getty Images

A woman holds pills and information for hormone replacement therapy

Types of Hormone Replacement Therapy

Hormone replacement therapy is made with either one or two types of hormones:

Each is available in different formulas and dosages.

Systemic Hormone Therapy

Systemic therapies allow the hormones—whether estrogen alone or with added progesterone—to circulate throughout the body via the bloodstream. This method impacts thevasomotor symptoms(night sweats and hot flashes) of menopause.

Systemic HRT is provided in the following ways:

Low-Dose Vaginal Products

Low-dose vaginal therapies release smaller amounts of hormones to the affected area through placement into the vagina.

Low-dose HRT is available in the form of a vaginal cream, ring, or tablet. They most often contain estrogen alone.

Vaginal Cream and How to Apply It

Benefits of Hormone Replacement Therapy

For many healthy adults who are experiencing moderate or severe menopausal symptoms, there are benefits to using hormone replacement therapy that may override potential risks of this treatment.

Medical experts note that the benefits of HRT can include:

In addition, the American College of Obstetrics and Gynecologists (ACOG) notes that otherwise healthy people who are experiencingearly menopauseorestrogen deficiencymay find HRT beneficial.

Hormone replacement therapy is recommended on an individual basis. It’s important to speak with a healthcare provider about the potential benefits and risks of HRT based on factors like your symptoms, medical history, and overall health.

Stacia Alexander on Her Experience With Menopause

Risks of Hormone Replacement Therapy

Many medical experts agree that hormone replacement therapy is an option worth considering for healthy adults under 60 seeking to manage certain menopausal symptoms.But it’s important to point out that research has highlighted several potentially serious risks of using HRT.

In particular, research that began in 2002 raised significant concerns, including that some participants on HRT had a higher risk of breast cancer, heart disease,stroke,blood clots,urinary incontinence,gallbladder disease, anddementia. The affected participants were mostly over the age of 60 andpast the menopausal stage.

Since then, researchers have continued to analyze these findings as they explore the long-term safety of HRT. Experts have clarified that the potential risks may be more likely in people who:

Anyone with these risk factors will not be considered a candidate for hormone replacement therapy.

To help avoid further risks in people who are prescribed HRT, the U.S. Food and Drug Administration (FDA) recommends using HRT at the lowest working dose for the shortest period of time possible, which is typically no longer than five years.

When HRT Is Not RecommendedHormone replacement therapy is notrecommended for people who:May be pregnantHave issues with abnormal vaginal bleedingHave a family or personal history of breast cancerHave a personal history of heart disease, stroke, blood clots, or liver diseaseHave a family history of gallbladder diseaseAre allergic to estrogen or progesterone

Hormone replacement therapy is notrecommended for people who:May be pregnantHave issues with abnormal vaginal bleedingHave a family or personal history of breast cancerHave a personal history of heart disease, stroke, blood clots, or liver diseaseHave a family history of gallbladder diseaseAre allergic to estrogen or progesterone

Hormone replacement therapy is notrecommended for people who:

Just as the transition to menopause is unique for every individual, the experience of taking hormone replacement therapy will be, too.

Like most medications, there are some common side effects that may occur with HRT, including:

Note that potential side effects can vary based on the type of hormone replacement therapy and dosage. If side effects become bothersome, talk to your healthcare provider before stopping medication.

Summary

Hormone replacement therapy (HRT) is a medical treatment that boosts declining levels of estrogen and progesterone in a person approaching menopause. It helps ease some menopausal symptoms, such as hot flashes, night sweats, and vaginal dryness. HRT can be used orally, topically, or vaginally.

While the benefits of HRT can be worthwhile for people looking for moderate to severe symptom relief, studies have shown that it comes with an increased chance of breast cancer, heart disease, and other serious health conditions. It’s important to talk to a healthcare provider about your medical history and personal risks before deciding whether HRT is right for you.

A Word From Verywell

The transition to menopause often comes with physical and emotional challenges, but your quality of life does nothave to suffer. Whether or not you decide to try hormone replacement therapy, know that there are other options to help youcope with the menopausal transition, including non-hormonal medications that can help with hot flashes and vaginal discomfort.

Frequently Asked QuestionsSymptoms of menopause—such as night sweats, hot flashes, and vaginal dryness—can be relieved with hormone replacement therapy. Check with a healthcare provider for more information on HRT if you’re approaching menopause and experiencing these symptoms.Learn MoreHow Age and Other Factors Affect PerimenopauseThere’s no solid evidence that taking hormone replacement therapy directly causes weight gain.However, hormonal changes that happen naturally during menopause in addition to lifestyle or physical activity factors often contribute to weight gain during this time.Learn MoreHow to Stop Weight Gain During MenopauseCommon side effects may include spotting, bloating, headaches, and breast soreness.

Symptoms of menopause—such as night sweats, hot flashes, and vaginal dryness—can be relieved with hormone replacement therapy. Check with a healthcare provider for more information on HRT if you’re approaching menopause and experiencing these symptoms.Learn MoreHow Age and Other Factors Affect Perimenopause

Symptoms of menopause—such as night sweats, hot flashes, and vaginal dryness—can be relieved with hormone replacement therapy. Check with a healthcare provider for more information on HRT if you’re approaching menopause and experiencing these symptoms.

Learn MoreHow Age and Other Factors Affect Perimenopause

There’s no solid evidence that taking hormone replacement therapy directly causes weight gain.However, hormonal changes that happen naturally during menopause in addition to lifestyle or physical activity factors often contribute to weight gain during this time.Learn MoreHow to Stop Weight Gain During Menopause

There’s no solid evidence that taking hormone replacement therapy directly causes weight gain.However, hormonal changes that happen naturally during menopause in addition to lifestyle or physical activity factors often contribute to weight gain during this time.

Learn MoreHow to Stop Weight Gain During Menopause

Common side effects may include spotting, bloating, headaches, and breast soreness.

26 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.WHI study data confirm short-term heart disease risks of combination hormone therapy for postmenopausal women.American College of Obstetricians and Gynecologists.Hormone therapy for menopause.American Cancer Society.Menopausal hormone therapy and cancer risk.Kopper NW, Gudeman J, Thompson DJ.Transdermal hormone therapy in postmenopausal women: a review of metabolic effects and drug delivery technologies.Drug Des Devel Ther. 2009;2:193-202. doi:10.2147/dddt.s4146MedlinePlus.Estrogen vaginal.Lindahl SH.Reviewing the options for local estrogen treatment of vaginal atrophy.Int J Womens Health. 2014;6:307-312. doi:10.2147/IJWH.S52555MedlinePlus.Aging changes in the female reproductive system.American Academy of Family Physicians.Hormone replacement therapy.Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny.2014;13(4):213-220. doi:10.5114/pm.2014.44996Barzi A, Lenz AM, Labonte MJ, Lenz HJ.Molecular pathways: estrogen pathway in colorectal cancer.Clin Cancer Res. 2013;19(21):5842-5848. doi:10.1158/1078-0432.CCR-13-0325Jang YC, Huang HL, Leung CY.Association of hormone replacement therapy with mortality in colorectal cancer survivor: a systematic review and meta-analysis.BMC Cancer.2019;19(1199). doi:10.1186/s12885-019-6428-0American College of Obstetrics and Gynecology.Hormone replacement therapy: what are the benefits of hormone therapy?.North American Menopause Society.Menopause topics: hormone therapy.National Cancer Institute.Menopausal hormone therapy and cancer.Rossouw JE, Anderson GL, Prentice RL, et al.Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial.JAMA. 2002;288(3):321-33. doi:10.1001/jama.288.3.321The NAMS 2017 Hormone Therapy Position Statement Advisory Panel.The 2017 hormone therapy position statement of the North American Menopause Society.Menopause. 2017;24(7):728-753. doi:10.1097/GME.0000000000000921Chester RC, Kling JM, Manson JE.What the Women’s Health Initiative has taught us about menopausal hormone therapy.Clin Cardiol. 2018;41(2):247-252. doi:10.1002/clc.22891Sood R, Faubion SS, Kuhle CL, Thielen JM, Shuster LT.Prescribing menopausal hormone therapy: an evidence-based approach.Int J Womens Health. 2014;6:47–57. doi:10.2147/IJWH.S38342U.S. Food and Drug Administration.Menopause.MedlinePlus.Hormone replacement therapy.MedlinePlus.Estrogen and progestin (hormone replacement therapy).U.S. Food and Drug Administration.Menopause: medicines to help you.Pachman DR, Jones JM, Loprinzi CL.Management of menopause-associated vasomotor symptoms: current treatment options, challenges and future directions.International Journal of Women’s Health.2010;2:123–135. doi:10.2147/ijwh.s7721National Health Service.Side effects of hormone replacement therapy.Gold EB, Block G, Crawford S, et al.Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women’s Health Across the Nation.Am J Epidemiol. 2004;159(12):1189-99. doi:10.1093/aje/kwh168Davis SR, Castelo-Branco C, Chedraui P, et al.Understanding weight gain at menopause.Climacteric. 2012;15(5):419-29. doi:10.3109/13697137.2012.707385

26 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.WHI study data confirm short-term heart disease risks of combination hormone therapy for postmenopausal women.American College of Obstetricians and Gynecologists.Hormone therapy for menopause.American Cancer Society.Menopausal hormone therapy and cancer risk.Kopper NW, Gudeman J, Thompson DJ.Transdermal hormone therapy in postmenopausal women: a review of metabolic effects and drug delivery technologies.Drug Des Devel Ther. 2009;2:193-202. doi:10.2147/dddt.s4146MedlinePlus.Estrogen vaginal.Lindahl SH.Reviewing the options for local estrogen treatment of vaginal atrophy.Int J Womens Health. 2014;6:307-312. doi:10.2147/IJWH.S52555MedlinePlus.Aging changes in the female reproductive system.American Academy of Family Physicians.Hormone replacement therapy.Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny.2014;13(4):213-220. doi:10.5114/pm.2014.44996Barzi A, Lenz AM, Labonte MJ, Lenz HJ.Molecular pathways: estrogen pathway in colorectal cancer.Clin Cancer Res. 2013;19(21):5842-5848. doi:10.1158/1078-0432.CCR-13-0325Jang YC, Huang HL, Leung CY.Association of hormone replacement therapy with mortality in colorectal cancer survivor: a systematic review and meta-analysis.BMC Cancer.2019;19(1199). doi:10.1186/s12885-019-6428-0American College of Obstetrics and Gynecology.Hormone replacement therapy: what are the benefits of hormone therapy?.North American Menopause Society.Menopause topics: hormone therapy.National Cancer Institute.Menopausal hormone therapy and cancer.Rossouw JE, Anderson GL, Prentice RL, et al.Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial.JAMA. 2002;288(3):321-33. doi:10.1001/jama.288.3.321The NAMS 2017 Hormone Therapy Position Statement Advisory Panel.The 2017 hormone therapy position statement of the North American Menopause Society.Menopause. 2017;24(7):728-753. doi:10.1097/GME.0000000000000921Chester RC, Kling JM, Manson JE.What the Women’s Health Initiative has taught us about menopausal hormone therapy.Clin Cardiol. 2018;41(2):247-252. doi:10.1002/clc.22891Sood R, Faubion SS, Kuhle CL, Thielen JM, Shuster LT.Prescribing menopausal hormone therapy: an evidence-based approach.Int J Womens Health. 2014;6:47–57. doi:10.2147/IJWH.S38342U.S. Food and Drug Administration.Menopause.MedlinePlus.Hormone replacement therapy.MedlinePlus.Estrogen and progestin (hormone replacement therapy).U.S. Food and Drug Administration.Menopause: medicines to help you.Pachman DR, Jones JM, Loprinzi CL.Management of menopause-associated vasomotor symptoms: current treatment options, challenges and future directions.International Journal of Women’s Health.2010;2:123–135. doi:10.2147/ijwh.s7721National Health Service.Side effects of hormone replacement therapy.Gold EB, Block G, Crawford S, et al.Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women’s Health Across the Nation.Am J Epidemiol. 2004;159(12):1189-99. doi:10.1093/aje/kwh168Davis SR, Castelo-Branco C, Chedraui P, et al.Understanding weight gain at menopause.Climacteric. 2012;15(5):419-29. doi:10.3109/13697137.2012.707385

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institutes of Health.WHI study data confirm short-term heart disease risks of combination hormone therapy for postmenopausal women.American College of Obstetricians and Gynecologists.Hormone therapy for menopause.American Cancer Society.Menopausal hormone therapy and cancer risk.Kopper NW, Gudeman J, Thompson DJ.Transdermal hormone therapy in postmenopausal women: a review of metabolic effects and drug delivery technologies.Drug Des Devel Ther. 2009;2:193-202. doi:10.2147/dddt.s4146MedlinePlus.Estrogen vaginal.Lindahl SH.Reviewing the options for local estrogen treatment of vaginal atrophy.Int J Womens Health. 2014;6:307-312. doi:10.2147/IJWH.S52555MedlinePlus.Aging changes in the female reproductive system.American Academy of Family Physicians.Hormone replacement therapy.Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny.2014;13(4):213-220. doi:10.5114/pm.2014.44996Barzi A, Lenz AM, Labonte MJ, Lenz HJ.Molecular pathways: estrogen pathway in colorectal cancer.Clin Cancer Res. 2013;19(21):5842-5848. doi:10.1158/1078-0432.CCR-13-0325Jang YC, Huang HL, Leung CY.Association of hormone replacement therapy with mortality in colorectal cancer survivor: a systematic review and meta-analysis.BMC Cancer.2019;19(1199). doi:10.1186/s12885-019-6428-0American College of Obstetrics and Gynecology.Hormone replacement therapy: what are the benefits of hormone therapy?.North American Menopause Society.Menopause topics: hormone therapy.National Cancer Institute.Menopausal hormone therapy and cancer.Rossouw JE, Anderson GL, Prentice RL, et al.Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial.JAMA. 2002;288(3):321-33. doi:10.1001/jama.288.3.321The NAMS 2017 Hormone Therapy Position Statement Advisory Panel.The 2017 hormone therapy position statement of the North American Menopause Society.Menopause. 2017;24(7):728-753. doi:10.1097/GME.0000000000000921Chester RC, Kling JM, Manson JE.What the Women’s Health Initiative has taught us about menopausal hormone therapy.Clin Cardiol. 2018;41(2):247-252. doi:10.1002/clc.22891Sood R, Faubion SS, Kuhle CL, Thielen JM, Shuster LT.Prescribing menopausal hormone therapy: an evidence-based approach.Int J Womens Health. 2014;6:47–57. doi:10.2147/IJWH.S38342U.S. Food and Drug Administration.Menopause.MedlinePlus.Hormone replacement therapy.MedlinePlus.Estrogen and progestin (hormone replacement therapy).U.S. Food and Drug Administration.Menopause: medicines to help you.Pachman DR, Jones JM, Loprinzi CL.Management of menopause-associated vasomotor symptoms: current treatment options, challenges and future directions.International Journal of Women’s Health.2010;2:123–135. doi:10.2147/ijwh.s7721National Health Service.Side effects of hormone replacement therapy.Gold EB, Block G, Crawford S, et al.Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women’s Health Across the Nation.Am J Epidemiol. 2004;159(12):1189-99. doi:10.1093/aje/kwh168Davis SR, Castelo-Branco C, Chedraui P, et al.Understanding weight gain at menopause.Climacteric. 2012;15(5):419-29. doi:10.3109/13697137.2012.707385

National Institutes of Health.WHI study data confirm short-term heart disease risks of combination hormone therapy for postmenopausal women.

American College of Obstetricians and Gynecologists.Hormone therapy for menopause.

American Cancer Society.Menopausal hormone therapy and cancer risk.

Kopper NW, Gudeman J, Thompson DJ.Transdermal hormone therapy in postmenopausal women: a review of metabolic effects and drug delivery technologies.Drug Des Devel Ther. 2009;2:193-202. doi:10.2147/dddt.s4146

MedlinePlus.Estrogen vaginal.

Lindahl SH.Reviewing the options for local estrogen treatment of vaginal atrophy.Int J Womens Health. 2014;6:307-312. doi:10.2147/IJWH.S52555

MedlinePlus.Aging changes in the female reproductive system.

American Academy of Family Physicians.Hormone replacement therapy.

Gambacciani M, Levancini M.Hormone replacement therapy and the prevention of postmenopausal osteoporosis.Prz Menopauzalny.2014;13(4):213-220. doi:10.5114/pm.2014.44996

Barzi A, Lenz AM, Labonte MJ, Lenz HJ.Molecular pathways: estrogen pathway in colorectal cancer.Clin Cancer Res. 2013;19(21):5842-5848. doi:10.1158/1078-0432.CCR-13-0325

Jang YC, Huang HL, Leung CY.Association of hormone replacement therapy with mortality in colorectal cancer survivor: a systematic review and meta-analysis.BMC Cancer.2019;19(1199). doi:10.1186/s12885-019-6428-0

American College of Obstetrics and Gynecology.Hormone replacement therapy: what are the benefits of hormone therapy?.

North American Menopause Society.Menopause topics: hormone therapy.

National Cancer Institute.Menopausal hormone therapy and cancer.

Rossouw JE, Anderson GL, Prentice RL, et al.Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial.JAMA. 2002;288(3):321-33. doi:10.1001/jama.288.3.321

The NAMS 2017 Hormone Therapy Position Statement Advisory Panel.The 2017 hormone therapy position statement of the North American Menopause Society.Menopause. 2017;24(7):728-753. doi:10.1097/GME.0000000000000921

Chester RC, Kling JM, Manson JE.What the Women’s Health Initiative has taught us about menopausal hormone therapy.Clin Cardiol. 2018;41(2):247-252. doi:10.1002/clc.22891

Sood R, Faubion SS, Kuhle CL, Thielen JM, Shuster LT.Prescribing menopausal hormone therapy: an evidence-based approach.Int J Womens Health. 2014;6:47–57. doi:10.2147/IJWH.S38342

U.S. Food and Drug Administration.Menopause.

MedlinePlus.Hormone replacement therapy.

MedlinePlus.Estrogen and progestin (hormone replacement therapy).

U.S. Food and Drug Administration.Menopause: medicines to help you.

Pachman DR, Jones JM, Loprinzi CL.Management of menopause-associated vasomotor symptoms: current treatment options, challenges and future directions.International Journal of Women’s Health.2010;2:123–135. doi:10.2147/ijwh.s7721

National Health Service.Side effects of hormone replacement therapy.

Gold EB, Block G, Crawford S, et al.Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women’s Health Across the Nation.Am J Epidemiol. 2004;159(12):1189-99. doi:10.1093/aje/kwh168

Davis SR, Castelo-Branco C, Chedraui P, et al.Understanding weight gain at menopause.Climacteric. 2012;15(5):419-29. doi:10.3109/13697137.2012.707385

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