It seems like everybody is talking about menopause, which is exciting because it’s a topic that has been under-researched and not discussed publicly for a long time.

At Diana Health, it’s important to us that you have evidence-based information about all things menopause, including hormone therapy. Below are answers to some of the most common questions we hear. We hope they help you better understand menopause hormone therapy and whether it’s something you’d like to discuss with your Diana Health women’s health clinician.

What Menopause Hormone Therapy Is

Menopause hormone therapy refers to prescription medications containing the hormones estrogen and progesterone, which are commonly used to treat symptoms associated with menopause—especially hot flashes.

You may also hear it called hormone replacement therapy (HRT). Today, many clinicians simply use the term hormone therapy because lower estrogen and progesterone levels after menopause are a normal part of aging and don’t always require “replacement.”

Hormone therapy works by providing estrogen—and, when appropriate, progesterone—to women whose symptoms are caused by fluctuating or low hormone levels during the menopause transition or because of certain medical conditions.

The Hormones Used in Menopause Therapy

Estrogen

Estrogen is almost always included in menopause hormone therapy because estrogen levels fluctuate and decline during menopause.

Estrogen can help:

• Reduce hot flashes
• Dease night sweats
• Support bone strength after menopause

Progesterone

Progesterone is recommended for women taking systemic estrogen who still have a uterus.

Taking estrogen alone can significantly increase the risk of uterine cancer in women with a uterus. Adding progesterone protects the lining of the uterus and helps reduce this risk.

Progesterone may also:

• Improve certain menopause symptoms
• Promote better sleep for some women
• Cause drowsiness, which is why it’s often taken at bedtime

Other Hormones

Other hormones, such as testosterone, may occasionally be used in menopause care, although they are prescribed much less frequently than estrogen and progesterone.

Ways to Take Menopause Hormone Therapy

There are several ways hormone therapy can be prescribed depending on your symptoms, preferences, and medical history.

Oral medications

Estrogen and progesterone can be taken by mouth as prescription pills.

They may be prescribed:

• As separate medications
• As a combination pill containing both hormones

Topical estrogen

Estrogen may also be prescribed as:

• Skin patches
• Creams
• Gels
• Vaginal rings

Your Diana Health clinician can help determine which delivery method best fits your needs.

Systemic vs. Vaginal Hormone Therapy

There are two primary ways hormone therapy is used.

Systemic hormone therapy

Systemic hormone therapy delivers hormones throughout the body.

It is commonly used to:

• Treat hot flashes
• Reduce night sweats
• Help prevent bone loss
• Treat women who experience early menopause

Hormone therapy is considered systemic when estrogen is delivered through:

• Pills
• Skin patches
• Gels
• Creams (used outside the vagina)

While systemic hormone therapy may improve vaginal symptoms for some women, it doesn’t always.

Local vaginal estrogen

Vaginal estrogen is different because it treats symptoms specifically affecting the vagina and nearby tissues.

It is commonly prescribed for genitourinary syndrome of menopause, which may include:

• Vaginal dryness
• Pain with intercourse
• Vaginal irritation
• Certain urinary symptoms

Vaginal estrogen comes in:

• Creams
• Tablets

Because the estrogen stays primarily within the vaginal tissues and only very small amounts enter the bloodstream:

• Progesterone is generally not needed
• The risk of uterine cancer is not significantly increased
• Many women can safely use vaginal estrogen for decades

Why Women Choose Hormone Therapy

Menopause hormone therapy is primarily recommended for:

• Hot flashes
• Night sweats
• Early menopause
• Prevention of bone loss

Some women also notice improvements in additional symptoms. Research in these areas is still evolving, and more studies are underway to better understand these potential benefits.

When Women Start Hormone Therapy

Women often begin hormone therapy when menopause symptoms become bothersome enough to affect daily life.

Some begin treatment:

• During perimenopause, when periods become irregular
• After menopause, once they’ve gone at least one year without a menstrual period

Most women who use systemic hormone therapy start before age 60, when the benefits are generally more likely to outweigh the risks.

There is no single recommended length of treatment.

Instead, women should review their:

• Symptoms
• Personal health history
• Risks
• Benefits

with their clinician each year to decide whether continuing therapy is right for them.

Some women stop hormone therapy after their hot flashes resolve, while others may benefit from longer treatment.

Understanding the Risks of Hormone Therapy

Over the past 20 years, researchers have learned much more about both the benefits and risks of menopause hormone therapy.

Although hormone therapy does carry some risks, it is considered a safe and effective treatment option for many women—particularly those who:

• Are younger than 60
• Are within 10 years of menopause

Hormone therapy is not appropriate for everyone.

For example, women with certain medical conditions, including:

• Estrogen receptor-positive cancers
• Active liver disease

may not be good candidates.

Many women worry that hormone therapy causes breast cancer. Today’s evidence shows that hormone therapy is safe for many women when used appropriately, which is why having an individualized conversation with your clinician is so important.

Deciding Whether Hormone Therapy Is Right for You

Hormone therapy can seem complicated, and every woman’s experience with menopause is different.

At Diana Health, our women’s health clinicians have extensive training in menopause care and hormone therapy. We’ll take time to understand:

• Your symptoms
• Your health history
• Your goals
• Your concerns

Together, we’ll review the potential benefits and risks of hormone therapy and determine whether it’s the right option for you. If it is, we’ll help choose the dose, medication, and delivery method that best fits your individual needs.

The Bottom Line

If you’re considering menopause hormone therapy, have questions about your symptoms, or simply want to better understand your options, we’re here to help.

At Diana Health, we’re committed to empowering women with evidence-based care and supporting your health throughout perimenopause, menopause, and beyond.