HRT or Not? Navigating the Options
- Judith Pringle
- Sep 14
- 2 min read

When menopause symptoms hit hard- the hot flashes, night sweats, sleepless nights, mood swings, or bone-thinning- many women wonder if hormone replacement therapy (HRT) is the answer.
For some, HRT is life-changing. For others, it’s not the right fit. The important thing is this: you have choices, and your decision should be guided by good information, not fear.
What Is HRT?
HRT (sometimes called MHT, or menopausal hormone therapy) replaces the estrogen and sometimes progesterone- your body no longer produces after menopause. It comes in several forms:
Pills
Patches
Gels or sprays
Vaginal creams, tablets, or rings
The type and dose depend on your symptoms, health history, and whether you still have a uterus.
The Benefits
Research shows HRT can:
Reduce hot flashes and night sweats
Improve sleep and mood
Ease vaginal dryness and pain during sex
Protect bone health and lower osteoporosis risk
Support brain health (some evidence suggests reduced risk of dementia when started early)
For many women, it feels like getting their life back.
The Considerations
HRT isn’t suitable for everyone. Risks can include:
A slightly increased risk of blood clots and stroke (especially with oral forms in older women)
A possible increased risk of breast cancer with long-term combined HRT (estrogen + progesterone)
Side effects like breast tenderness, bloating, or mood changes
Your age, family history, and timing matter. Starting HRT within 10 years of menopause (or before age 60) is generally considered safest.
The Alternatives if HRT isn’t right for you, there are other ways to manage symptoms:
Lifestyle: exercise, sleep hygiene, balanced diet
Non-hormonal medications (certain antidepressants, blood pressure meds) can reduce hot flashes
Vaginal moisturizers and lubricants for dryness
Supplements (like magnesium for sleep, omega-3s for mood)- though evidence varies
How to Decide
The decision to use HRT is deeply personal. It’s not about being “pro” or “anti”- it’s about being pro-you.
Steps to Clarity:
Identify your top 3 symptoms and how they affect your quality of life
Know your health history (family risks, past conditions)
Book a conversation with a menopause-informed provider
Give yourself permission to revisit the decision- you’re not locked in forever
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