Hormone Therapy & You: What the Research Really Says
Few menopause topics stir as much conversation as hormone therapy (often called HT or HRT). For some, it’s been life-changing relief. For others, it raises questions and caution. The truth is — both perspectives are valid. Science continues to evolve, and every woman’s health profile is unique.
Let’s walk through what the research actually says, what it doesn’t, and how to approach the decision with confidence and context.
A Little History
Hormone therapy became common in the 1980s and 1990s, promoted as a way to ease symptoms and protect long-term health. That changed in 2002 when the Women’s Health Initiative (WHI) study reported higher rates of certain health risks in women taking a combination of estrogen and progestin compared to placebo (WHI).
The findings led to widespread concern — and a dramatic drop in prescriptions. But later analyses have shown that the timing, type, and dose of hormone therapy all play significant roles in its effects and safety profile. (Be sure to talk through your options with your doctor)
What We Know from Current Evidence
Potential Benefits
Symptom relief: Hormone therapy remains the most effective treatment for moderate to severe vasomotor symptoms (hot flashes, night sweats) and vaginal dryness. (Mayo Clinic)
Bone health: Estrogen helps slow bone loss and can reduce fracture risk, especially in early postmenopause. (NIH Osteoporosis and Related Bone Diseases Resource Center)
Quality of life: For some women, HT can improve sleep, mood, and overall daily comfort, particularly when symptoms are disruptive.
Considerations & Risks
Individual factors matter. Age, time since menopause, type of hormones used, dosage, and method of delivery (pill, patch, gel, etc.) all affect risk-benefit balance.
Possible risks: Research shows a small increased risk of breast cancer with combined estrogen-progestin therapy, and a slightly higher risk of blood clots and stroke for certain formulations, particularly when started later in life. (The North American Menopause Society 2022 Position Statement)
Heart health: Starting HT closer to the onset of menopause (within 10 years) may have a different cardiovascular effect than starting later — a concept known as the timing hypothesis.
What It Does Not Do
Hormone therapy is not a universal anti-aging treatment.
It doesn’t guarantee protection from heart disease or cognitive decline.
It’s also not the only option — non-hormonal therapies, lifestyle strategies, and alternative medications can all play roles depending on your health history and symptom profile.
Making an Informed Choice
If you’re considering HT, it’s best approached as a personalized medical decision, not a blanket recommendation.
Here’s how to think about it:
Have a detailed conversation with your healthcare provider. Bring up your age, symptoms, medical history, and any personal or family risk factors (especially breast cancer, heart disease, or clotting disorders).
Discuss forms and doses. Some women respond better to low-dose or transdermal (patch/gel) options, which may carry different risk profiles.
Reevaluate regularly. HT isn’t “one and done.” Most experts recommend reviewing annually to assess whether the benefits still outweigh any potential risks.
Combine with lifestyle care. Exercise, nutrition, sleep, and stress management remain essential parts of symptom control and long-term well-being.
Bottom Line
Hormone therapy can be transformative for some and unsuitable for others. The goal isn’t to promote or dismiss it — it’s to make sure every woman has clear, evidence-based information and the support to decide what’s best for her own body.
Whether you choose HT, natural management, or a mix of both, you deserve accurate knowledge — not confusion or shame.
That’s what The Pause Moment is here for: clarity, compassion, and your right to choose your path through the pause.
