Hormone Therapy: What Every Woman Should Know
by Silvia Diaz-Roa
Hormone therapy (HT) is one of the most effective ways to manage symptoms of menopause—but thanks to decades-old fears, many women avoid it altogether.
Let’s break down the facts and clear up the confusion.
What Is Hormone Therapy?
Hormone therapy (also known as hormone replacement therapy or HRT) involves supplementing your body with estrogen, progesterone, or both—hormones that naturally decline during menopause.
HT can be delivered in different ways:
Pills
Patches
Gels
Creams
Vaginal rings or inserts
The goal is to reduce symptoms like hot flashes, night sweats, vaginal dryness, and mood swings—and to support long-term health, including bone and heart health.
Why the Controversy?
Much of the fear around hormone therapy comes from the Women’s Health Initiative (WHI) study in the early 2000s. Headlines at the time suggested that HT increased the risk of breast cancer, heart disease, and stroke.
But here’s what’s often left out:
The study focused on women in their 60s who started HT years after menopause.
Many participants were already at risk for health issues.
Later analysis found that younger women (in their 40s and 50s) starting HT near the onset of menopause had very different outcomes.
The North American Menopause Society (NAMS) and other experts now emphasize that for many women, the benefits outweigh the risks—especially when started early.
What Can Hormone Therapy Help With?
HT is considered the gold standard for:
Hot flashes and night sweats
Vaginal dryness and discomfort during sex
Sleep disturbances
Mood swings and irritability
Bone loss prevention
Some studies even suggest cognitive benefits and potential heart protection when started early in menopause.
What About the Risks?
Like any medical treatment, hormone therapy isn’t risk-free. The risks depend on:
Your age
Your health history (especially breast cancer, blood clots, or heart disease)
The type and route of HT
Talk to a menopause-informed provider who can assess your individual risks and benefits. For many healthy women under 60 or within 10 years of menopause, HT is safe and beneficial.
Types of Hormone Therapy
Systemic HT (body-wide) – used for full-body symptoms like hot flashes and night sweats. Delivered via pills, patches, or gels.
Local/Vaginal HT – low-dose estrogen applied directly to the vaginal area for dryness and urinary symptoms. Minimal absorption, low risk.
Is Bioidentical Better?
The term "bioidentical" refers to hormones that are chemically identical to those your body produces. Some FDA-approved HT options are bioidentical. Others are made in compounding pharmacies.
Key point: FDA-approved, regulated hormone therapy (whether bioidentical or not) is safe. Custom-compounded hormones are less studied and less regulated.
Bottom Line
Hormone therapy isn’t right for everyone—but for many women, it can be life-changing.
It’s safe for healthy women under 60 or within 10 years of menopause onset.
It effectively treats common menopause symptoms.
It may support bone, brain, and heart health.
It’s time to stop letting outdated headlines make your health decisions. Talk to your provider and explore what’s best for you.
