HRT during Menopause: The good, the Bad and the Uncertain

hormone replacement therapy menopause

Many women start to experience menopause symptoms a few years before the actual onset of their menopause.

These symptoms most commonly are hot flashes, night sweats and flushing.

However, in some cases, symptoms may be more severe and may even adversely affect the quality of life.

Menopause Treatment

Various forms of treatment exist, such as hormone replacement therapy (HRT), natural remedies and lifestyle adjustments.

In this article, we will take a closer look at HRT. This treatment option may be effective in women under the age of 60, or within 10 years of menopause onset.

The Uncertain

HRT has been no stranger to uncertainty and controversy. It was widely used to treat the symptoms of menopause in the last half of the 20th Century. But, in 2002 and 2003, studies linked this treatment to some cancers and other health risks, such as an increased risk of blood clots and stroke. Many doctors stopped prescribing it. This caused as much as a two-thirds drop in use. Then, ten years later, in 2012, further studies found that HRT wasn’t so bad, after all.

So, what to believe?

The Bad

As oestrogen levels drop when your ovaries release eggs less and less regularly, the hot flushes, night sweats, insomnia, mood swings, vaginal dryness and other symptoms can be truly debilitating.

Oestrogen’s balancing hormone, progesterone, has the job of preparing the uterus for pregnancy and protecting its lining, the endometrium. Although less progesterone doesn’t cause menopausal symptoms, it is often prescribed along with oestrogen to guard against the risk of uterine or endometrial cancer.

Using a combination of oestrogen and progesterone slightly increases your risk of getting breast, uterine and ovarian cancer, as well as that of suffering stroke, deep vein thrombosis and pulmonary embolism. However, experts say if it is used over a short period (two to five years), the benefits outweigh the risks.

If you suffer from high blood pressure, migraine, or have had thrombosis, stroke, or heart disease, then HRT is probably not the way to go and you should consider alternative treatments (see Navigating Menopause: Naturally).

The Good

The good news is that the pendulum has now swung back in favour of HRT. If used correctly, HRT has improved the quality of millions of menopausal women’s lives. These days it is considered an effective and relatively safe treatment for the symptoms of menopause.

It is always important to consider the benefits as well as risks when taking medication. Every woman responds to menopause in her own way, so make sure your doctor takes into account your medical history, risk factors and personal preferences. And go for a check-up at least once a year.

It is important that you use HRT only as long as you suffer menopausal symptoms (no longer than five years) and that you take the lowest dose possible.

Recent studies have also suggested that HRT may have side benefits such as improving muscle function, reducing the risk of heart attack, and slowing down the ageing process of your skin. But although the later studies have cast HRT in a better light, a lot of uncertainty still surrounds the treatment. Experts warn against using the treatment for more than five years. If you use it for longer than 10 years, your doctor should review your health and HRT dose at least once a year.


HRT may not be as dangerous as previously thought, but make the decision on whether or not to go this route in consultation with your doctor to make sure you receive the treatment and dosages that are right for you.

By Linda Cilliers


The Content on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

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