Hormone therapy (HRT) replaces the estrogen — and, for most people with a uterus, progesterone too — that the body produces less of during menopause. It's the most effective treatment available for hot flashes and night sweats, and it can also help with vaginal dryness and bone density. It comes in several forms: pills, patches, gels, sprays, and rings, each with a different absorption pattern and different considerations.
A common misconception is that HRT is uniformly risky for everyone — the actual picture depends heavily on age, time since menopause, personal and family health history, and the type and route of hormone used. For most healthy people who start HRT within about ten years of menopause or before age 60, current major medical guidelines consider the benefits to generally outweigh the risks for symptom relief — but "most people" is not "everyone," which is exactly why this is a decision made with a clinician who knows your individual history, not from a general article.
Good questions to bring to that conversation include: which type and route might suit me, how soon might I notice a difference, what would we monitor over time, and what would make us reconsider the plan. If you're already on HRT, logging your dose, route, and how consistently you're taking it — alongside your symptoms — gives your clinician a much clearer picture than memory alone at your next visit.
Quick answers
Why do some people also need progesterone?
Estrogen alone can thicken the lining of the uterus over time. For anyone who still has a uterus, a progestogen is added to protect the lining. If you have had a hysterectomy, estrogen on its own is usually used.
Which form is best?
There is no single best form. Pills, patches, gels, and sprays all treat hot flashes. Some research suggests that skin (transdermal) forms carry a lower risk of blood clots than pills, which is one reason clinicians often discuss them first for people with certain risk factors. Low-dose vaginal estrogen treats vaginal and urinary symptoms and has very little absorption into the rest of the body.
What are the main risks?
They depend on your age, how long it has been since menopause, your health history, and the type of therapy. The risks discussed most often are blood clots (mainly with pills), and a small increase in breast cancer risk with long-term combined estrogen and progestogen therapy. For many healthy people under 60 or within ten years of menopause, current guidelines consider the benefits for troublesome symptoms to outweigh the risks, but your own history is what matters.
Who may not be able to use it?
Hormone therapy is generally not recommended for people with a history of certain cancers (such as breast cancer), blood clots, stroke, liver disease, or unexplained vaginal bleeding. Your clinician will go through this with you.
How long can I stay on it?
There is no fixed time limit. The usual approach is to use the lowest dose that controls your symptoms and to review the plan with your clinician regularly, often once a year.
How logging helps
If you are on hormone therapy, noting your dose, route, and how consistently you take it next to your symptoms gives your clinician a clearer picture than memory alone. Pausa keeps your regimen history on your device and can include it in a summary you choose to share.
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