Hormone therapy

Menopausal hormone therapy (often called HRT) replaces the estrogen your ovaries stop making, with a progestogen added if you still have a uterus. It is the most effective treatment for hot flashes and night sweats, cutting their frequency by about 75% in trials, and it prevents bone loss. For healthy women under 60 or within 10 years of menopause with bothersome symptoms, US guidelines conclude the benefits outweigh the risks, and the serious risks are rare in absolute terms.

Where to start

New to the topic? Read what is menopausal hormone therapy, then is hormone therapy safe? for the real numbers. If you still have periods, see hormone therapy in perimenopause vs after menopause. When you are ready to discuss it, use how to talk to your doctor about hormone therapy.

Hormone therapy at a glance

Question	Short answer	Read the guide
What does it treat?	Hot flashes, night sweats and vaginal dryness; it also prevents bone loss	What is hormone therapy
How risky is it?	Serious risks are rare under 60 or within 10 years of menopause	Is hormone therapy safe?
What about breast cancer?	Estrogen plus a progestogen adds about 9 cases per 10,000 women per year in the WHI; estrogen alone did not raise risk	Breast cancer risk
Where did the fear come from?	The WHI was a prevention trial in women averaging 63; harms were concentrated in older women	The WHI study explained
Who should not take it?	Past breast cancer, blood clot, stroke or heart attack, unexplained bleeding or liver disease	Who should not take HRT?
What side effects are common?	Breast tenderness, spotting, bloating; spotting usually stops within 6 months	HRT side effects
Patch or pill?	Equally effective; patches showed no increase in blood clots, oral estrogen about 1.6-fold	The estrogen patch
Progesterone or progestin?	Both protect the uterine lining; micronized progesterone is identical to the body’s own	Progesterone vs progestin
What about vaginal estrogen?	Low-dose local treatment for dryness and urinary symptoms; very little reaches the blood	Vaginal estrogen
Are bioidentical hormones better?	FDA-approved estradiol and progesterone are already bioidentical; compounded versions are not shown to be safer	Bioidentical hormones
How long can I take it?	No fixed limit; review the decision every year	How long can you take HRT?
Before your final period?	Cyclic progestogen or a hormonal IUD; it is not contraception	Perimenopause vs after menopause

What changed recently

In November 2025 the FDA asked manufacturers to remove heart disease, breast cancer and probable dementia from the boxed warning on menopausal hormone therapy and to add that therapy may be considered for women under 60 or within 10 years of menopause. That information remains elsewhere in the label, and the endometrial cancer warning stays for estrogen used alone. The change does not make hormone therapy risk-free, and it is still not approved to prevent heart disease or dementia. On sleep, see micronized progesterone and hormone therapy and sleep.

When to see a clinician

If hot flashes, night sweats or sleep loss are affecting your life, discuss treatment, even while you still have periods. Bring a symptom log and your family history of breast cancer, clots, stroke and heart disease. A refusal based on age alone, or an offer of compounded hormones instead of FDA-approved products, is a reason to seek a second opinion. Call promptly for a new breast lump, unusual bleeding, or chest or leg pain. If estrogen is not an option, see non-hormonal treatments. The symptom check helps you prepare, and the directory lists clinicians near you.