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If you’re going through menopause and your doctor suggests hormone therapy, you probably have some questions.

First up are probably: What is hormone therapy? Is this treatment right for me? What are the signs that you need hormone therapy?

Here’s what you need to know about hormone therapy.

What Is Hormone Therapy for Women?

Hormone therapy (formerly called hormone replacement therapy or HRT) is a medical treatment for symptoms of menopause. Doctors use hormones to treat symptoms like hot flashes and night sweats. Your doctor may recommend hormone therapy with estrogen, progestin, or both.

You may take hormone therapy by mouth, as a patch on your skin, or as a cream or tablet in your vagina. Your doctor can talk to you about which form is right for you.

What Is Menopause?

Menopause is the time in your life when your periods stop. For most women, that’s around 51 years old. Perimenopause is the transitional time before menopause, usually starting around your mid-40s.

Some women go through menopause at a younger age. Doctors use the term premature menopause for menopause that happens before the age of 40.

Premature menopause may happen because you had your ovaries surgically removed. (Removal of the uterus, or hysterectomy, stops periods but doesn’t cause menopause.)

What are common menopausal symptoms?

Menopausal symptoms happen as your hormone levels start to decline.  You may have vasomotor symptoms like flushing, hot flashes, and night sweats. These can occur when shifting hormone levels suddenly widen and narrow your blood vessels.

Other menopausal symptoms include:

• Brain fog.
• Depression.
• Frequent urination.
• Joint pain.
• Mood swings.
• Sleep problems.
• Thinning hair.
• Vaginal dryness.
• Weight gain around the waist.

What Does Estrogen Do?

Estrogen is a female sex hormone primarily produced by the ovaries. It regulates your menstrual cycle and plays a role in your reproductive health. But starting in perimenopause, your estrogen levels start to decline.

By the time you reach menopause, your ovaries no longer release eggs and you don’t have periods. You can’t become pregnant. (You can still become pregnant in perimenopause when your periods are irregular.)

Types of Hormone Therapy

There are several types of hormone therapy. They help relieve menopausal symptoms by mimicking the hormones your body produces.

• Combination therapy — Combines estrogen and progesterone. If you still have a uterus, your doctor will prescribe this form of hormone therapy. It comes in pill, patch, or intrauterine device (IUD) forms.
• Estrogen therapy — For people who have had a hysterectomy (removal of the uterus). It comes in several forms, including pill, patch, and gel.
• Vaginal estrogen therapy — This method applies directly to the vagina. It comes in ring, tablet insert, and vaginal cream forms. It’s most effective at relieving symptoms like vaginal dryness and painful sex.

Is Hormone Therapy Safe?

For most women, hormone therapy is safe. Women with certain medical conditions shouldn’t have hormone therapy. It’s important to talk to your doctor about your medical history, so they can weigh the benefits and risks of hormone therapy.

It’s better to start taking hormone therapy when menopausal symptoms begin rather than waiting until symptoms get worse. Ongoing use of hormone therapy will depend on your symptoms, overall health, treatment goals, and personal preferences.

Benefits of hormone therapy

The main benefit of hormone therapy is to reduce vasomotor symptoms. Most women on hormone therapy experience fewer hot flashes, night sweats, mood swings, insomnia, and brain fog.

Hormone therapy for menopause may also:

• Improve bladder function — Many menopausal women have an overactive bladder. You may have to pee less often when you take hormone therapy.
• Improve bone health — Osteoporosis is a potential side effect of menopause. Hormone therapy can help protect your bones and prevent fractures as you get older.
• Lower your risk of diabetes — Women who use hormone therapy have a lower risk of developing type 2 diabetes.
• Lower your risk of heart disease —Hormone therapy may lower your risk of cardiovascular disease, especially if you start taking it early in menopause.
• Provide vaginal relief — Low-dose vaginal estrogen therapy helps thinning vaginal walls, providing relief from vaginal dryness and painful sex.

Risks of hormone therapy

That hormone therapy is dangerous is a myth. Overall, hormone therapy is safe. But for some women, the risks of hormone therapy may outweigh the benefits.

You shouldn’t take hormone therapy if you’ve ever had:

• Blood clots
• Breast cancer
• Endometrial cancer
• Heart attack
• Liver disease
• Stroke
• Uterine cancer

The risks of hormone therapy include:

• Blood clots — The risk of blood clots is higher with hormone therapy taken by mouth. Using a patch, gel, or spray limits risk.
• Breast cancer — You can use estrogen therapy for up to seven years before the risk of breast cancer increases. The risk goes up after three to five years for women who use combination therapy.
• Stroke — Hormone therapy may increase the risk of having a stroke, but this risk decreases when you stop taking it.
• Uterine cancer — The risk of uterine cancer is higher with estrogen therapy. If you still have a uterus, your doctor will recommend combination therapy.

Other side effects of hormone therapy

Like any medication, there are some common side effects with hormone therapy. They include:

• Breast tenderness.
• Irregular bleeding or spotting.
• Nausea. 

Questions to Ask Your Doctor

Many women find relief from menopause symptoms with hormone therapy. Still, it’s important to talk to your doctor about the pros and cons of hormone therapy and whether it’s right for you.

Questions to ask include:

• How long will I take hormone therapy?
• How often do I need to take hormone therapy?
• What are the risks of hormone therapy given my medical history?
• What form of hormone therapy do you recommend?
• What is the lowest dose of estrogen for menopause symptoms?

Other Ways to Treat Menopausal Symptoms

Whether or not you take hormone therapy, lifestyle changes can help you manage bothersome symptoms of menopause. You can relieve hot flashes and other menopausal symptoms by:

• Developing good sleep habits — To help you sleep through the night, knock off screen time at least an hour before bedtime. Keep your room cool and dark and go to bed at the same time every night.
• Exercising for 30 minutes five times a week — Moving your body can help you sleep better, boost your mood, and calm menopausal symptoms. Try walking, biking, or swimming.
• Figuring out and avoiding your hot flash triggers — Alcohol, spicy foods, or caffeine can set off a hot flash or keep you up at night.
• Keeping it cool — Lower the temperature in your house.
• Maintaining a healthy weight — Being overweight or obese can make menopausal symptoms worse.
• Quitting smoking — Nicotine makes menopausal symptoms worse and is bad for your overall health.
• Trying relaxation techniques — Yoga, tai chi, and meditation can help relieve stress.
• Wearing lightweight clothing — Choose clothes made of breathable fabric like cotton. Layer pieces so you can remove outerwear during a hot flash.

Editor's Note: This article was originally published on May 29, 2025, and was last reviewed on June 11, 2025.