Hormone replacement therapy for better health

Hormone replacement therapy (HRT) is a treatment that can help women with common symptoms during perimenopause. It gives your body some of the hormones that fall before and after menopause. Learn more about what HRT is, who it may help, the types of treatment available and what to know about safety and side effects.

During perimenopause, for some women, hormone levels may drop. This can lead to symptoms such as hot flashes and vaginal dryness. To help ease these symptoms, some people take hormone medicines. This is sometimes called menopausal hormone therapy.^{1, 2}

The ovaries make less of the hormones estrogen and progesterone during perimenopause. Hormone therapy replaces some of these hormones with artificial estrogen and progesterone.³

Hormone therapy may also reduce your chances of getting osteoporosis and colon cancer.^{1, 2}

Hormone therapy is not safe if you are pregnant. Stop taking it if you become pregnant or think you might be.²

You can take systemic or low-dose HRT.⁴

With systemic therapy, hormones enter the body through pills, patches, sprays, gels or a vaginal ring. This can help treat menopause symptoms like hot flashes.⁴

Low-dose therapy is also called vaginal estrogen therapy. Medicine is put into the vagina to help with dryness and rebuild tissue. An example is a vaginal cream, ring or tablet that melts inside the vagina. Only a small amount enters your blood, so there are fewer risks.^{4, 5}

Many factors should be considered before starting HRT. Common factors include age, overall health, symptom severity and cost.

HRT is safe for some people. Like any medicine, it also has risks. The U.S. Food and Drug Administration (FDA) says people should use the lowest dose that works for the shortest time needed.^{1, 3}

Hormone therapy can make some women more likely to have blood clots, heart attacks, strokes, breast cancer and gall bladder problems. If a woman still has her uterus, taking estrogen alone can raise the risk of getting cancer in the lining of the uterus. Adding progestin helps lower this risk.¹

Taking estrogen alone or with progesterone can make you slightly more likely to have a stroke and blood clots. This is not common for women between 50 and 59.³

Younger women and those close to their last period have fewer risks from hormone therapy.³

Some risks depend on your health and your family’s history. If you are thinking about hormone therapy, talk with your OB/GYN about your choices and any risks.²

If these side effects bother you or last a long time, talk to your OB/GYN. You might be able to change your dose.²

Bioidentical hormones are made from plants. They are a lot like the hormones your body makes. Some kinds, like oral progesterone, are approved by the FDA. Others are compounded drugs.²

Compounded drugs are not regulated by the FDA. Custom hormone mixes can be risky because they may have too much or too little hormone. You might not know the strength. Pellet therapy, a type of compounded drug, also has safety concerns.¹

The hormone estriol is not FDA-approved. Drugs that contain estriol are compounded drugs, which are not FDA-approved.¹

The American College of Obstetricians and Gynecologists (ACOG) recommends FDA-approved hormone therapy instead of compounded hormone therapy.²