Hormone Replacement Therapy (HRT): Types, Evidence, Risks, Who It Helps, and What to Ask Your Doctor

Hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT), uses prescription estrogen, progesterone or testosterone to replace hormones the body no longer makes in adequate amounts, most often to treat hot flashes, night sweats, vaginal dryness and bone loss after menopause, or symptomatic low testosterone in men. For healthy women under 60 or within 10 years of menopause, The Menopause Society's 2022 position statement concludes that the benefits of HRT for symptom relief and fracture prevention outweigh the risks, while risks such as blood clots, stroke and breast cancer rise with older age at starting, oral estrogen and longer use of combined therapy.

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What Is Hormone Replacement Therapy?

Your body runs on hormones. They regulate everything from your mood and energy to your bone density, heart health, and sex drive. When hormone levels drop, whether from aging, surgery, or medical conditions, the effects can be dramatic. Brain fog, hot flashes, weight gain, insomnia, depression, loss of muscle mass: these are not just inconveniences. They erode your quality of life.

Hormone replacement therapy (HRT) is exactly what it sounds like. It replaces the hormones your body is no longer making in adequate quantities. For women, that typically means estrogen and progesterone. For men, it usually means testosterone (often called TRT, or testosterone replacement therapy). Some protocols include DHEA, thyroid hormones, or pregnenolone as well.

HRT has been around for decades, but its reputation took a serious hit in 2002 when one study scared millions of women off their prescriptions. The section on the evidence below explains that study and why later analyses changed the picture. The short version: when prescribed correctly, monitored properly, and started at the right time, HRT is the most effective treatment available for hot flashes and night sweats, according to The Menopause Society's 2022 position statement.

Other Names for HRT

Doctors and researchers use several names for the same treatment. Menopausal hormone therapy (MHT) and hormone therapy (HT) are the terms most guidelines now use. Estrogen therapy (ET) means estrogen alone, and estrogen plus progestogen therapy (EPT) means combined treatment. Bioidentical hormone replacement therapy (BHRT) refers to hormones with the same structure as the body's own, and TRT is the usual name for testosterone replacement in men.

HRT is prescribed by gynecologists, primary care physicians, endocrinologists, urologists, nurse practitioners and physician assistants, and integrative or functional medicine doctors. The HRT treatment guide covers how the therapy works, and the menopause condition page explains the symptoms it is most often used for.

Types of Hormone Replacement Therapy

Bioidentical vs. Synthetic Hormones

This is the first decision point, and it matters more than most people realize.

Synthetic hormones have a different molecular structure. Premarin (conjugated equine estrogens, derived from pregnant horse urine) and Provera (medroxyprogesterone acetate) are the most well-known examples. They activate the same receptors as your natural hormones, but because their shape is slightly different, they can produce different side-effect profiles.

Most integrative and functional medicine doctors now prefer bioidentical hormones, and many menopause specialists prefer transdermal estradiol with micronized progesterone as a first choice. Observational studies, including the French E3N cohort, suggest that micronized progesterone (brand name Prometrium) carries a smaller breast cancer risk signal than the synthetic progestins used in the WHI study. Those data come from observational cohorts rather than head-to-head randomized trials, so the difference is likely but not settled.

Bioidentical does not have to mean compounded. Estradiol patches, gels and tablets and micronized progesterone capsules are FDA-approved bioidentical products made to standardized doses. A 2020 report from the National Academies of Sciences, Engineering, and Medicine found too little evidence to support routine use of compounded bioidentical hormones over approved products, which is why The Menopause Society reserves compounding for patients who need a dose or ingredient that no approved product offers.

The Key Hormones in HRT

Estrogen is the primary female sex hormone. It protects bones, supports cardiovascular health, keeps skin elastic, maintains vaginal and urinary tract tissue, and plays a critical role in brain function. Estrogen replacement is the single most effective treatment for hot flashes, night sweats, and vaginal dryness.

Progesterone balances estrogen’s effects on the uterine lining. Any woman with an intact uterus who takes estrogen must also take progesterone to prevent endometrial hyperplasia (overgrowth of the uterine lining, which can lead to cancer). Progesterone also has calming, sleep-promoting properties that many women appreciate. A levonorgestrel intrauterine device (IUD) is another way some clinicians protect the uterine lining.

Testosterone is not just for men. Women produce testosterone too, and levels decline with age. Low testosterone in women can cause low libido, fatigue, and loss of muscle mass. The 2019 Global Consensus Position Statement on testosterone for women (Davis et al.) supports it only for postmenopausal women with hypoactive sexual desire disorder, and no testosterone product is FDA-approved for women in the US, so prescriptions for women are off label. In men, testosterone replacement (TRT) addresses hypogonadism and its related symptoms: fatigue, depression, erectile dysfunction, loss of strength, and cognitive decline.

Delivery Methods Compared

Method	Hormones Available	Pros	Cons
Transdermal patch	Estrogen, testosterone	Steady levels, bypasses liver, lower clot risk	Can irritate skin, may fall off
Topical cream/gel	Estrogen, progesterone, testosterone	Easy to apply, adjustable dosing	Can transfer to others via skin contact, absorption varies
Oral pills	Estrogen, progesterone	Convenient, well-studied	First-pass liver metabolism, slightly higher clot risk for estrogen
Subcutaneous pellets	Estrogen, testosterone	Lasts 3 to 6 months, very steady levels	Requires minor in-office procedure, hard to adjust dose once placed
Injections	Testosterone, estrogen (less common)	Precise dosing, reliable absorption	Peaks and troughs between doses, requires needles
Vaginal ring/cream/tablet	Estrogen	Targets local symptoms, minimal systemic absorption	Only treats vaginal/urinary symptoms

There is no single “best” delivery method. Your doctor should help you choose based on your symptoms, health history, lifestyle, and preferences. Many women start with patches or creams because they bypass the liver and carry the lowest risk of blood clots.

Estrogen pellets are not FDA-approved in the US, and The Menopause Society advises against them because the dose cannot be lowered once a pellet is placed and blood levels can climb well above the normal range. Low-dose vaginal estrogen, by contrast, treats atrophic vaginitis and other genitourinary symptoms with very little of the hormone reaching the bloodstream.

Who Is HRT For?

Women in Menopause

The average age of menopause in the US is 51. By this point, estrogen and progesterone production has dropped dramatically. Common symptoms include hot flashes, night sweats, sleep disruption, mood changes, vaginal dryness, painful intercourse, urinary urgency, joint pain, and difficulty concentrating. HRT treats most of these symptoms, with the strongest evidence for hot flashes, night sweats and vaginal symptoms. The menopause HRT guide goes deeper on choosing a regimen.

Women in Perimenopause

Perimenopause can begin as early as your late 30s and typically starts in the mid-40s. Hormone levels fluctuate wildly during this phase. You might have cycles that are suddenly heavier, lighter, closer together, or further apart. Sleep worsens. Anxiety spikes. Many women are told “you are too young for menopause” and sent home without help. Perimenopause can be a good time to start HRT, because treating symptoms early can also limit the rapid bone loss that begins in the menopause transition. The perimenopause guide covers the early signs in detail.

Surgical Menopause

Women who have had their ovaries removed (oophorectomy) experience an immediate, dramatic drop in hormones. This is surgical menopause, and the symptoms are often more severe than natural menopause because the decline happens overnight rather than gradually. HRT is strongly recommended for these women, especially if surgery happens before age 45, to protect bone and brain health.

Premature ovarian insufficiency (POI), when the ovaries stop working before 40, is treated the same way. NICE guideline NG23 and The Menopause Society both advise hormone therapy for women with POI or early menopause until at least the average age of natural menopause, unless there is a specific reason not to. More on recovery after oophorectomy is in the surgical menopause guide.

Men with Low Testosterone

Testosterone in men declines roughly 1% per year after age 30. Some men maintain adequate levels well into old age; others drop low enough to cause real problems by their 40s or 50s. Symptoms of low T include persistent fatigue, low motivation, reduced muscle mass, increased body fat (especially belly fat), erectile dysfunction, depression, and brain fog. When bloodwork confirms low levels, testosterone replacement therapy can meaningfully improve libido, energy and mood for many men. We cover TRT in detail on our dedicated TRT page.

Who Should Not Take HRT?

Systemic estrogen is generally not prescribed to women with the conditions below, according to The Menopause Society (2022) and FDA product labeling. Some of these are absolute exclusions and some call for specialist input.

• Current or past estrogen-receptor-positive breast cancer, or endometrial cancer.
• Unexplained vaginal bleeding, which needs evaluation first (see postmenopausal bleeding).
• A past blood clot (deep vein thrombosis or pulmonary embolism), stroke, or heart attack.
• Active liver disease.
• Pregnancy, or a known clotting disorder.

For men, the Endocrine Society (2018) advises against testosterone therapy in men planning a pregnancy soon, and in men with breast or prostate cancer, a hematocrit above 50%, untreated severe sleep apnea, or uncontrolled heart failure.

How Long Does HRT Take to Work?

Most women notice fewer hot flashes and night sweats within a few weeks of starting estrogen, and the full effect usually takes about 3 months, according to NHS guidance. NICE guideline NG23 recommends a review 3 months after starting or changing HRT, then at least once a year. Vaginal estrogen often takes several weeks to a few months to restore comfort.

1. Weeks 1 to 4: Sleep and hot flashes begin to improve. Breast tenderness, bloating or spotting are common while the body adjusts.
2. Months 1 to 3: Most vasomotor symptoms settle. Mood, joint aches and brain fog may improve, though evidence for these is weaker.
3. Month 3 review: Your prescriber checks symptoms, bleeding pattern and blood pressure and adjusts the dose or route if needed.
4. Year 1 and beyond: An annual review weighs ongoing benefits against your current risk factors.

In men, the Endocrine Society (2018) recommends checking testosterone levels and symptoms 3 to 6 months after starting TRT, then yearly, along with hematocrit and, in older men, prostate monitoring.

The Evidence: What the Research Actually Shows

The WHI Study and Its Fallout

In 2002, the Women’s Health Initiative (WHI) trial made global headlines. The study, reported in JAMA by Rossouw and colleagues (2002), found that women taking a specific combination of conjugated equine estrogen (Premarin) plus synthetic progestin (Provera) had slightly elevated rates of breast cancer, heart attack, and stroke. Panic followed. Millions of women abandoned HRT overnight. Doctors stopped prescribing it.

The problem? The study had serious design limitations that took years to fully appreciate:

• The average age of participants was 63, meaning most women were more than a decade past menopause when they started hormones.
• The study used synthetic progestins, not bioidentical progesterone.
• It used oral conjugated equine estrogens, not transdermal estradiol.
• The absolute risk increases were tiny (8 additional breast cancer cases per 10,000 women per year).
• The estrogen-only arm of the study (for women without a uterus) actually showed a decrease in breast cancer risk.

A later WHI follow-up by Manson and colleagues (JAMA, 2013) analyzed results by age and found that the absolute risks were lowest in women aged 50 to 59, which shaped the timing guidance that followed.

The “Timing Hypothesis” and Modern Understanding

This is called the “timing hypothesis,” and it has been supported by multiple subsequent analyses, including reanalysis of the original WHI data. The 2022 position statement from The Menopause Society (formerly NAMS) confirms that for healthy women under 60 or within 10 years of menopause, the benefits of HRT outweigh the risks. The Danish DOPS trial (Schierbeck et al., BMJ, 2012) also reported fewer cardiovascular events in recently postmenopausal women who took HRT for about 10 years.

The Lancet published a 2019 meta-analysis by the Collaborative Group on Hormonal Factors in Breast Cancer, pooling data on more than 100,000 women with breast cancer. It found that most types of systemic HRT, including estrogen alone, were linked with some increase in breast cancer risk that grew with years of use, while low-dose vaginal estrogen was not. The European Menopause and Andropause Society (EMAS) issued updated guidelines in 2021. The consensus across major medical organizations: individualized HRT, using the right formulations at the right time, has a favorable benefit to risk balance for most symptomatic women under 60.

What Did the FDA Change in 2025?

On November 10, 2025, the FDA announced that it would remove the boxed warning language about cardiovascular disease, breast cancer and probable dementia from menopausal hormone therapy labels. The boxed warning about endometrial cancer stays on systemic estrogen-alone products. The FDA's labeled recommendation is now to start systemic HRT before age 60 or within 10 years of menopause onset, and in February 2026 the agency approved the first updated labels.

The label change does not make HRT a prevention drug. The US Preventive Services Task Force (2022) still recommends against using hormone therapy solely to prevent chronic conditions such as heart disease or osteoporosis in postmenopausal women, and The Menopause Society treats symptom relief as the main reason to start.

Benefits of HRT

The best-documented benefits of HRT are relief of hot flashes and night sweats, prevention of bone loss and fractures, and treatment of vaginal and urinary symptoms. The table below rates each benefit by the strength of the evidence behind it.

Benefit	Details	Strength of Evidence
Hot flash and night sweat relief	Reduces frequency and severity by 75% or more in most women	Strong (gold-standard RCTs)
Bone density protection	Reduces hip fracture risk by approximately 33%	Strong
Cardiovascular protection	When started early, reduces coronary heart disease events	Moderate to strong
Improved sleep	Reduces night sweats and may improve sleep quality independently	Moderate
Vaginal and urinary health	Reverses vaginal atrophy, reduces urinary tract infections	Strong
Mood and cognition	Reduces menopause-related depression and brain fog	Moderate
Skin health	Maintains collagen production and skin thickness	Moderate
Sexual function	Improves libido and reduces pain with intercourse	Moderate
Possible Alzheimer’s risk reduction	Early evidence suggests early HRT may reduce dementia risk; the WHI Memory Study found higher dementia risk when combined HRT was started at 65 or older	Emerging (observational data)

The dementia evidence is the least settled row in the table. The WHI Memory Study (Shumaker et al., JAMA, 2003) found more dementia among women who began estrogen plus progestin at 65 or older, and The Menopause Society does not recommend HRT to prevent dementia at any age. For joint aches, brain fog and mood, many women report improvement, but trial data are weaker than for hot flashes and bone.

Risks and Side Effects

Blood clots (venous thromboembolism): Oral estrogen increases clotting risk slightly. Transdermal estrogen (patches, creams, gels) does not appear to carry this same risk, making it the preferred route for women with clotting concerns or obesity.

Breast cancer: Combined estrogen-plus-progestin therapy (especially with synthetic progestins) is associated with a small increase in breast cancer risk after 5+ years of use. In the WHI randomized trial, estrogen alone did not increase this risk and was linked with fewer cases, although the 2019 Lancet meta-analysis of observational data found a smaller rise with estrogen alone. Bioidentical progesterone appears to carry less risk than synthetic progestins, though long-term data is still maturing.

Stroke: Oral estrogen is associated with a slight increase in stroke risk. Transdermal estrogen at standard doses does not appear to carry this risk.

Gallbladder disease: Oral estrogen increases gallbladder disease risk. Again, transdermal delivery avoids this issue.

Endometrial cancer: Estrogen taken without a progestogen raises the risk of endometrial cancer in women who still have a uterus. That is why combined therapy is standard for these women, and why the FDA kept the endometrial cancer boxed warning on systemic estrogen-alone products.

Common side effects (usually temporary): Breast tenderness, bloating, headaches, mood changes, and breakthrough bleeding. These typically resolve within the first 1 to 3 months as your body adjusts. Dose adjustments often help. Bleeding that starts after the first few months, or after a long gap, should be checked. The HRT side effects guide covers each one and how prescribers manage it.

HRT for Men: The TRT Connection

When we talk about HRT for men, we are almost always talking about testosterone replacement therapy (TRT). Male hormone optimization has gained enormous traction in recent years as awareness of low testosterone and its effects has grown. Urologists, endocrinologists and men's health clinics are the usual prescribers, and the testosterone replacement therapy guide explains the diagnosis in more depth.

The symptoms of low testosterone in men mirror many menopause symptoms in women: fatigue, mood disturbance, cognitive decline, loss of muscle, increased body fat, reduced libido, and poor sleep. Diagnosis requires bloodwork showing total testosterone below approximately 300 ng/dL (though symptoms can appear at higher levels in some men, particularly when free testosterone is low). The Endocrine Society's 2018 guideline asks for two fasting, early morning measurements before diagnosing hypogonadism, and uses 264 ng/dL as the lower limit of normal in healthy young men.

TRT options for men include:

• Intramuscular or subcutaneous injections (testosterone cypionate or enanthate), typically weekly or twice weekly
• Topical gels or creams (applied daily)
• Subcutaneous pellets (inserted every 3 to 6 months)
• Nasal gels (Natesto, applied 2 to 3 times daily)
• Clomiphene citrate (off-label, stimulates natural production, preferred for men who want to preserve fertility)

Testosterone suppresses sperm production, so men who want children are usually steered toward clomiphene or similar options instead. TRT also raises red blood cell counts, which is why hematocrit is checked at each review.

For a deep dive into protocols, bloodwork targets, side effects, and monitoring, visit our full TRT guide. To compare prescribers, the national list of TRT clinics shows practices that offer testosterone therapy.

Non-Hormonal Alternatives to HRT

Women who cannot or do not want to take hormones have several prescription options for hot flashes. The FDA approved fezolinetant, a neurokinin 3 receptor antagonist, in 2023, and low-dose paroxetine is also FDA-approved for hot flashes. Other SSRIs and SNRIs such as escitalopram and venlafaxine, plus gabapentin and oxybutynin, are used off label. The Menopause Society's 2023 nonhormone therapy position statement also supports cognitive behavioral therapy and clinical hypnosis.

For vaginal dryness and painful sex, vaginal moisturizers and lubricants are first-line options. Ospemifene (an oral selective estrogen receptor modulator) and vaginal prasterone (DHEA) are FDA-approved for painful intercourse caused by menopause. These alternatives are generally less effective than estrogen for hot flashes, but they give women with breast cancer or clotting history real choices. The menopause treatment guide compares hormonal and non-hormonal approaches side by side.

What Does HRT Cost?

Generic estradiol patches, pills and micronized progesterone are usually the least expensive forms of HRT, while pellets and compounded hormones cost the most and are less often covered by insurance. The estimates below are typical monthly ranges.

Treatment	Monthly Cost (Without Insurance)	Monthly Cost (With Insurance)	Notes
Estradiol patch (generic)	$30 to $80	$5 to $30 copay	Most insurance plans cover generic patches
Estradiol cream/gel	$50 to $150	$10 to $40 copay	Divigel, Estrogel, and generics available
Oral estradiol	$15 to $40	$5 to $15 copay	Very affordable generic option
Micronized progesterone (Prometrium)	$30 to $90	$5 to $25 copay	Generic widely available
Testosterone cream (women)	$40 to $120	Often not covered	Usually compounded at a pharmacy
Hormone pellets	$200 to $500 per insertion	Sometimes covered	Insertions every 3 to 6 months
TRT injections (men)	$40 to $100	$10 to $30 copay	Testosterone cypionate is very affordable
Compounded bioidentical hormones	$80 to $300	Usually not covered	Custom formulations from compounding pharmacies

These numbers are approximate and vary by region, pharmacy, and specific formulation. Many clinics that specialize in hormone optimization charge a monthly membership fee (typically $100 to $300) that includes bloodwork, consultations, and medications. Ask whether a quoted fee covers lab work and follow-up visits, because those can add to the total.

How to Find a Provider

Not all doctors are comfortable prescribing or monitoring HRT. If your primary care physician dismisses your symptoms or refuses to discuss hormones, you have options:

1. Look for a provider who specializes in hormone health. Board-certified endocrinologists, reproductive endocrinologists, and gynecologists with a focus on menopause are good starting points.
2. Consider a functional or integrative medicine doctor. These practitioners often have more training in bioidentical hormones and individualized protocols.
3. Check The Menopause Society’s provider directory at menopause.org for certified menopause practitioners (the MSCP credential, formerly NCMP).
4. Hormone optimization clinics specialize in exactly this. Many offer telemedicine consultations, at-home lab kits, and direct-to-patient medication shipping.
5. Ask the right questions. Does the provider use bioidentical hormones? Do they monitor bloodwork regularly? Do they individualize dosing, or do they use a one-size-fits-all approach? A good provider will tailor your protocol to your labs, symptoms, and goals.

The Regenerated.com directory of HRT clinics across the United States lists practices that offer hormone therapy, with state and city pages for narrowing the search. Listing order on those pages is not a paid ranking. Featured slots are clearly labeled and capped, Verified means the clinic completed credential checks rather than paid for placement, and the directory is free for patients. Inclusion in the directory is not an endorsement, so use the list as a starting point and ask each clinic the questions below. The guide to Featured, Verified and organic listings explains each label.

Questions to Ask Your Doctor About HRT

A good HRT consultation covers your symptoms, your personal and family history, and how treatment will be monitored. These questions help you get clear answers in one visit.

1. Which hormones do I need, and why? Ask whether you need estrogen alone, estrogen with progesterone, or testosterone, based on whether you have a uterus and what your symptoms are.
2. Is a patch, gel, pill or vaginal product best for me? Ask how the route affects your clot, stroke and gallbladder risk given your weight, blood pressure and history.
3. Is this product FDA-approved or compounded? If compounded, ask why an approved product will not work and which accredited pharmacy will fill it.
4. How does my breast cancer and heart disease risk change? Ask for your own numbers based on age, years since menopause and family history.
5. How will we monitor treatment? Ask when the first review is, which tests you will need, and what bleeding or side effects should prompt a call.
6. How long should I stay on HRT, and how would we stop? Ask how often the decision is reviewed and whether a taper is planned.
7. What are my non-hormonal options? Ask what you could try if HRT is not right for you or does not help enough.

Frequently Asked Questions

Is HRT safe?

For most healthy women under 60 or within 10 years of menopause onset, HRT has more benefits than risks, according to The Menopause Society (2022) and current FDA labeling. The key factors are timing (earlier is better), formulation (micronized progesterone is often preferred), and route (transdermal estrogen carries less clot risk than oral). Risks rise with age, duration and a personal or family history of breast cancer or blood clots, so discuss those with your doctor.

How long can I stay on HRT?

There is no mandatory stop date. The old “use it for five years and quit” advice was based on the WHI data and is now considered outdated for many women. The Menopause Society (2022) supports continuing past age 60 or 65 when benefits still outweigh risks, with an annual reassessment. Some women stay on low-dose HRT into their 70s for symptoms or bone protection. Your provider should review the decision with you every year.

Will HRT make me gain weight?

HRT does not cause weight gain in clinical trials. Estrogen replacement can help limit the shift toward abdominal fat that commonly happens in menopause. Some women notice mild water retention in the first few weeks, but this typically resolves. Progesterone can increase appetite in some women. Overall, most data suggests HRT is weight-neutral or slightly beneficial for body composition, while age, sleep and activity drive most midlife weight change.

What about “natural” alternatives to HRT?

Supplements like black cohosh, red clover and soy isoflavones have mixed evidence and much weaker effects than prescription HRT. Lifestyle changes such as exercise, stress management, sleep hygiene and less alcohol help some women with mild symptoms. For moderate to severe hot flashes, prescription non-hormonal options such as fezolinetant or low-dose paroxetine have stronger evidence than supplements. For vaginal atrophy and frequent hot flashes, HRT remains the most effective treatment available.

Can I take HRT if I have had breast cancer?

This depends on the type of breast cancer. For women with a history of estrogen-receptor-positive breast cancer, systemic HRT is generally contraindicated. Low-dose vaginal estrogen may be considered in some cases for severe urogenital symptoms, and non-hormonal options such as fezolinetant, SSRIs and vaginal moisturizers exist. Women with estrogen-receptor-negative breast cancer may have more flexibility, but this decision requires careful discussion with your oncologist.

Do I need bloodwork before starting HRT?

Women over 45 with typical symptoms usually do not need hormone tests to start HRT, because NICE and The Menopause Society diagnose menopause from symptoms and cycle history. Many integrative providers still check estradiol, FSH, thyroid function, vitamin D and a metabolic panel as a baseline. Men do need testing: the Endocrine Society requires two fasting, early morning testosterone levels before TRT, with follow-up labs at 3 to 6 months and then yearly.

What is the difference between compounded and commercial HRT?

Commercial (FDA-approved) HRT products are manufactured to standardized doses and undergo rigorous quality testing. Compounded hormones are custom-mixed by a pharmacy to a specific prescription. Both can use bioidentical hormones. Compounding pharmacies face less FDA oversight, so strength and purity can vary. If you use compounded hormones, choose a PCAB-accredited pharmacy. Compounded options are useful when you need a dose or combination not available commercially.

Related Guides

Hormone health does not exist in isolation. If you are exploring HRT, these related treatments and topics may be relevant to you:

• Peptide Therapy: Growth hormone secretagogues, BPC-157, and other peptides that complement hormone optimization.
• Menopause Guide: A deep dive into the menopause transition, symptom management, and long-term health strategies.
• NAD+ IV Therapy: Cellular energy support that many patients combine with hormone therapy, though evidence for the combination is limited.
• Bioidentical Hormone Therapy: How FDA-approved and compounded bioidentical hormones differ, and what the evidence says about each.
• HRT for Women: Estrogen and progesterone regimens, from perimenopause through the years after menopause.

Sources

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2. Manson JE, Chlebowski RT, Stefanick ML, et al. “Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women’s Health Initiative Randomized Trials.” JAMA. 2013;310(13):1353-1368.
3. The 2022 Hormone Therapy Position Statement of The Menopause Society. Menopause. 2022;29(7):767-794.
4. Collaborative Group on Hormonal Factors in Breast Cancer. “Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-analysis of the Worldwide Epidemiological Evidence.” The Lancet. 2019;394(10204):1159-1168.
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6. Bhasin S, Brito JP, Cunningham GR, et al. “Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline.” The Journal of Clinical Endocrinology & Metabolism. 2018;103(5):1715-1744.
7. European Menopause and Andropause Society (EMAS). “EMAS Position Statement: Individualized HRT for Menopausal Women.” Maturitas. 2021;154:62-70.
8. Boardman HM, Hartley L, Eisinga A, et al. “Hormone Therapy for Preventing Cardiovascular Disease in Post-menopausal Women.” Cochrane Database of Systematic Reviews. 2015;(3):CD002229.
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10. National Institute for Health and Care Excellence. “Menopause: Identification and Management” (NG23). Updated 2024.
11. US Food and Drug Administration. “HHS Advances Women’s Health, Removes Misleading FDA Warnings on Hormone Replacement Therapy.” Press announcement, November 10, 2025.

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This page is for informational purposes only. It is not medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any hormone therapy regimen. Content last reviewed March 2026.