Hormone Therapy for Menopause: What Women Need to Know

October 05, 2025By Nona Woman

Menopause is a natural phase in a woman’s life, typically occurring between the ages of 45 and 55, when the ovaries gradually stop producing estrogen and progesterone. While it’s a normal biological process, the hormonal changes can bring uncomfortable symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness. For many women, hormone therapy (HT) — also known as hormone replacement therapy (HRT) — can be an effective option to ease these symptoms and improve quality of life.

What Is Hormone Therapy?

Hormone therapy involves supplementing the body with estrogen alone or a combination of estrogen and progesterone(or progestin, a synthetic form). The main goal is to replace the hormones that decline during menopause, helping to balance the body’s systems and reduce symptoms.

Estrogen therapy (ET) is typically prescribed for women who have had a hysterectomy, while combination therapy (estrogen plus progesterone) is used for women with an intact uterus to prevent endometrial cancer caused by unopposed estrogen.

The Benefits of Hormone Therapy

Hormone therapy is considered the most effective treatment for vasomotor symptoms (such as hot flashes and night sweats) and genitourinary syndrome of menopause (vaginal dryness, discomfort, and urinary symptoms).

In addition to symptom relief, HT can help:

Maintain bone density and reduce the risk of postmenopausal osteoporosis.
Improve sleep and mood, as hormonal balance can reduce anxiety and irritability.
Support sexual health, by improving vaginal lubrication and elasticity.

Some studies also suggest potential benefits for cardiovascular health if therapy is started close to the onset of menopause — the so-called “timing hypothesis”.

The Risks and Considerations

Like any medical treatment, hormone therapy is not without risks. The Women’s Health Initiative (WHI) study in the early 2000s raised concerns about increased risks of breast cancer, stroke, and blood clots with certain types of combined HT). However, later analyses clarified that these risks vary based on age, health status, and timing of initiation.

Women who start HT before age 60 or within 10 years of menopause generally experience more benefits than risks. Conversely, starting therapy much later may carry higher cardiovascular and thrombotic risks.

HT is not recommended for women with a history of breast cancer, liver disease, unexplained vaginal bleeding, or active blood clots.

Personalized Approach Is Key

Experts now emphasize a personalized, lowest-effective-dose approach tailored to each woman’s symptoms, medical history, and preferences. Non-hormonal options — such as SSRIs, lifestyle changes, and herbal supplements — can also be considered for those unable or unwilling to use hormones.

Women interested in HT should consult a healthcare provider specializing in menopause management to discuss options, risks, and follow-up care.

Menopause is not an illness but a transition — and with the right support, women can move through it with balance, vitality, and confidence.

References:

Hodis, H. N., & Mack, W. J. (2014). Menopausal hormone therapy and the timing hypothesis: New insights from the Early versus Late Intervention Trial with Estradiol. Menopause, 21(9), 887–897. https://doi.org/10.1097/GME.0000000000000230
Manson, J. E., Chlebowski, R. T., Stefanick, M. L., Aragaki, A. K., Rossouw, J. E., Prentice, R. L., & Anderson, G. L. (2013). Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA, 310(13), 1353–1368. https://doi.org/10.1001/jama.2013.278040
North American Menopause Society (NAMS). (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028
Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Kooperberg, C., Stefanick, M. L., & Writing Group for the Women's Health Initiative Investigators. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women’s Health Initiative randomized controlled trial. JAMA, 288(3), 321–333. https://doi.org/10.1001/jama.288.3.321
Santen, R. J., Allred, D. C., Ardoin, S. P., Archer, D. F., Boyd, N., Braunstein, G. D., & Stuenkel, C. A. (2020). Postmenopausal hormone therapy: An Endocrine Society scientific statement. Journal of Clinical Endocrinology & Metabolism, 105(6), 1696–1722. https://doi.org/10.1210/clinem/dgaa048