Although every woman goes through menopause – and most experience at least some symptoms – only 20-25% will seek treatment.1 Many women accept menopause as just part of growing older. But for those whose hot flashes and other symptoms cause a significant impact on quality of life, hormone therapy is an option.
The first FDA-approved hormonal treatment for menopause was introduced in 1942. For years the treatment was termed hormone replacement therapy (HRT). But according to Sarah Block, APNP-CNP, an SSM Health Women’s Health provider, “The terminology has evolved over time. The Menopause Society, which is the academic resource for all things menopause in North America, recommends the terminology of hormone therapy (HT).” The name shift recognizes the goal of symptom relief instead of restoring a pre-menopausal hormone level.
What is hormone therapy?
As a woman approaches menopause, her body produces fewer of the hormones that control ovulation and support pregnancy. This can cause changes in the length and volume of your period, hot flashes, vaginal dryness, and trouble sleeping. Hormone therapy helps relieve these symptoms by increasing estrogen and progesterone levels. These hormones can be delivered in pill form, patches, and vaginal creams.
What are the pros and cons of hormone therapy?
“The benefits are abundant,” Block noted. “Not only will hormone therapy alleviate symptoms related to low estrogen but it also reduces risks for osteoporosis, cardiovascular disease, and dementia/Alzheimer's.” In fact, she says that women who have been suffering with symptoms commonly report that hormone therapy is “life-changing.“
But there can be some downsides to treatment. According to Block, “Cons include potential side effects like breast tenderness, water retention/bloating, and spotting.” She mentioned that these side effects typically dissipate as you adjust to treatment.
Is hormone therapy safe for everyone?
In general, hormone therapy is considered safe and effective for healthy women under age 60 or those within 10 years of the onset of menopause. Block added that the recommendation is for patients to receive “the appropriate amount for the appropriate amount of time,” based on need.
But Block indicates that deciding who can take it safely remains a hotly debated question. “The Menopause Society lists multiple contraindications to using hormone therapy,” she said. “Those include unusual uterine bleeding, history of heart attack or deep vein thrombosis, or a history of breast cancer or other estrogen-dependent cancer. Pregnant women and those with liver disease are also told to avoid HT.”
And she noted, “It is not generally recommended to start hormone therapy after age 65, as there is an increased risk of dementia. However, there are no absolutes and decisions are made between the patient and provider.”
Block added, “As more research emerges, we are seeing some of these conditions considered less of a concern. It boils down to severity of symptoms and acceptance of potential risks.”
Talk to your provider
Like all medications, hormone therapy for menopause symptom relief offers both risks and benefits. Have a conversation with your Women’s Health provider to determine if hormone therapy might be a good option for you.
1. Women in Menopause Often Go Untreated, AARP Public Policy Institute, April 17, 2025, https://www.aarp.org/pri/topics/health/conditions-treatment/menopause-women-untreated/
