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Hormone Replacement Therapy
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Women

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is used to manage symptoms of menopause, though it carries specific risks that require careful discussion with a healthcare provider.

Menopause is the time in a woman's life when her period stops. It is a normal part of aging. In the years before and during menopause, the levels of female hormones can go up and down. This can cause symptoms such as hot flashes, night sweats, pain during sex, and vaginal dryness. For some women, the symptoms are mild, and they go away on their own. Other women take hormone replacement therapy (HRT), also called menopausal hormone therapy, to relieve these symptoms. HRT may also protect against osteoporosis.

Who Should Avoid HRT

HRT is not for everyone. You should not use HRT if you:

  • Think that you are pregnant
  • Have problems with vaginal bleeding
  • Have had certain kinds of cancers
  • Have had a stroke or heart attack
  • Have had blood clots
  • Have liver disease

Types and Risks

There are different types of HRT. Some have only one hormone, while others have two. Most are pills that you take every day, but there are also skin patches, vaginal creams, gels, and rings.

Taking HRT has some risks. For some women, hormone therapy may increase their chances of getting blood clots, heart attacks, strokes, breast cancer, and gallbladder disease. Certain types of HRT have a higher risk, and each woman's own risks can vary, depending upon her medical history and lifestyle. You and your health care provider need to discuss the risks and benefits for you. If you do decide to take HRT, it should be the lowest dose that helps and for the shortest time needed. You should check if you still need to take HRT every 3-6 months.

Frequently Asked Questions

Women with a history of migraines with aura are at a higher baseline risk for stroke, and HRT can further increase this risk. Most guidelines advise against using systemic HRT in these individuals, though low-dose vaginal estrogen may be considered for local symptoms under strict medical supervision.
The window of opportunity generally refers to starting HRT within ten years of menopause onset or before age 60. Starting during this period is associated with the most favorable risk-benefit profile for cardiovascular health and bone density, whereas starting later may carry higher risks of adverse cardiovascular events.
You should not stop HRT abruptly without consulting your healthcare provider, as sudden discontinuation can cause a rapid return of severe menopausal symptoms like hot flashes and night sweats. Your doctor may recommend a gradual tapering schedule to minimize these withdrawal effects and ensure your body adjusts safely.
Oral estrogen pills must pass through the liver, which can increase the production of clotting factors and slightly raise the risk of blood clots compared to transdermal methods. Patches, gels, and sprays deliver hormones directly through the skin into the bloodstream, bypassing the liver, which generally results in a lower risk of venous thromboembolism for many patients.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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