Menopausal hormone therapy

Hormone therapy (HT) is medicine used to treat symptoms of menopause, such as hot flashes and vaginal dryness. It may contain one or both of the hormones estrogen and progestin.

Like all medicines, HT has some risks. But for many people, the benefits of taking HT outweigh the risks. Talk with your doctor about whether HT is right for you.

Hormone therapy includes:

• Low-dose vaginal estrogen (cream, tablet, or ring). These forms are mainly used to treat vaginal dryness and other tissue changes in and around the vagina.
• Estrogen and progestin therapy. This form of HT sends hormones throughout the body. It can come in the form of a pill, patch, vaginal ring, gel, spray, or cream. Estrogen and progestin therapy is most often used to treat menopause symptoms in people who have a uterus.
• Estrogen therapy (ET). This is the use of estrogen without progestin. This form of HT also sends hormones throughout the body. Most people who use ET have had their uterus removed (hysterectomy).

Taking HT can increase the risk of certain health problems for some people. But many people can take HT safely with little risk. Talk with your doctor about the risks and benefits of HT for you. A person's risk can depend on:

Age and when HT is started in menopause.

Short-term use of HT in early menopause has less risk than when it is started later in menopause.

• Starting HT later in menopause. This may increase the risk of heart disease, breast cancer, blood clots, stroke, dementia, urinary incontinence, and gallbladder disease.
• Starting HT earlier in menopause. This has much less risk. But it may slightly increase the risk of breast cancer, blood clots, stroke, urinary incontinence, and gallbladder disease.

Health history.

HT is not recommended if you:

• Could be pregnant.
• Have a personal history of blood clots, heart attack, or stroke.
• Have vaginal bleeding from an unknown cause.
• Have active liver disease.

If you have a history of breast or endometrial cancer, you may be able to take some types of HT but not others. Ask your doctor.

The type of HT.

• Low-dose vaginal estrogen HT, such as a cream, has less risk than other forms of HT.
• Risk can depend on whether estrogen is given alone or with progestin. If you don't have a uterus, your doctor may recommend estrogen-only HT. But if you do have a uterus, estrogen and progestin therapy is a safer option.