The Role of HRT: Myth-Busting and Facts

Hormone Replacement Therapy (HRT) is one of the most discussed—and often misunderstood—treatments for menopause.

Before considering HRT, it’s important to understand the different types and what is available. The type of HRT recommended depends on whether you have a uterus, your symptoms, and your personal risk factor - all this needs to be discussed with your Doctor - but you should never try to self diagnose or borrow your friend’s. It can take a while to find the right dosage for you and is highly personal.a

There are different types of HRT based on the hormones used

Oestrogen-only HRT

Suitable for women who have had a hysterectomy (removal of the uterus).

Helps relieve symptoms like hot flashes, vaginal dryness, and bone loss.

Common forms: tablets, patches, gels, sprays, or vaginal preparations.

Combined HRT (Estrogen + Progestogen)

Recommended for women who still have a uterus to protect the womb lining from overgrowth (which could lead to cancer).

Comes in two types:

Cyclical (Sequential) HRT – Mimics a natural cycle, with estrogen taken continuously and progestogen added for part of the month. Suitable for women still having some periods.

Continuous Combined HRT – Estrogen and progestogen are taken daily. Suitable for postmenopausal women (more than 12 months without a period

Body-identical HRT

Uses regulated, pharmaceutical-grade hormones that are structurally identical to those naturally produced by the body.

Often preferred for safety and effectiveness (e.g., micronized progesterone and transdermal estrogen).

Testosterone replacement

Sometimes prescribed to women experiencing low libido, brain fog, or fatigue.

Not licensed for women in many countries but can be prescribed off-label.

Once you have a basic understanding of what is available, and you understand that HRT ISN’T AN INSTANT SOLUTION TO CURING EVERYTHING MENOPAUSAL, read on as I’m going to separate fact from fiction so that you can make an informed decision about whether HRT is right for you.

MYTH 1 - HRT will magically make all your menopause symptoms disappear

FACT: HRT has been proven to help with various symptoms like hot flushes, mood swings, cognitive function or joint pain but it will not magically fix the inflammation or ageing inside your body which are key factors to metabolic syndrome. It won’t regulate your insulin resistance or detox your liver or reboot your adrenal glands. HRT must always go hand in hand with positive lifestyle changes.

MYTH 2 - HRT is dangerous and causes cancer

FACT: The fear surrounding HRT largely stems from a 2002 study that linked it to an increased risk of breast cancer. However, this study has since been widely re-evaluated, with experts clarifying that for most women, the benefits of HRT outweigh the risks. The risk of breast cancer is small and depends on factors like the type of HRT, duration of use, and personal medical history.

MYTH 3 - HRT is only for severe menopause symptoms

FACT: HRT is effective not just for severe symptoms but also for improving long-term health, such as reducing the risk of osteoporosis, heart disease, and cognitive decline. Women with mild symptoms may still benefit from HRT if it improves their quality of life.

MYTH 4 - Natural remedies are safer than HRT

FACT: While some women find relief with herbal supplements, these are not always regulated and may not be as effective as HRT. Moreover, “natural” does not always mean safe—some supplements can interfere with medications or have unwanted side effects. HRT is carefully regulated and prescribed based on individual needs. Never self medicate or borrow a friend’s!

MYTH 5 - You can only take HRT for a few years

FACT: There is no strict time limit on using HRT. Women can take it for as long as the benefits outweigh the risks, which is a decision made between a woman and her healthcare provider. Some women continue HRT into their 70’s and beyond if it enhances their well-being.

MYTH 6 - HRT will make you gain weight

FACT: There is no evidence that HRT causes weight gain. Menopause itself can lead to changes in body composition due to hormonal shifts, so if you are already overweight, the excess oestrogen that HRT brings you can end up being stored in the white adipose fat cells which are endocrine active therefore produce more oestrogen and expand with more fat which remains a cycle.

MYTH 7 - HRT is only available as tablets

FACT: HRT comes in many forms, including patches, gels, sprays, skin implants and vaginal treatments. These options allow women to tailor their treatment to their lifestyle and medical needs. For example, transdermal (through the skin) options carry a lower risk of blood clots than oral HRT.

MYTH 8 - HRT just delays menopause

FACT: HRT does not delay menopause; it replaces the hormones that your body is no longer producing at the same levels. When you stop taking HRT, menopausal symptoms may return, but this varies from person to person.

MYTH 9 - HRT must be started before you hit perimenopause

FACT: This used to be believed however, recent studies have shown that you can even start HRT in post menopause now should you want to. Hormone levels are still fluctuating in our 50’s so if you are still suffering with symptoms then HRT will help, whatever your age. It has been shown that the earlier you start, the lesser your symptoms but it is up to the individual at which point they decide to start.

MYTH 10 - HRT is a shameful last resort for women that can’t cope

FACT: There is absolutely no shame whatsoever in taking HRT. It isn’t about vanity or about giving up, it’s about your health - your mental and emotional wellbeing which should always be be your number 1 priority. It’s about a freedom of choice and it’s about knowing what suits you and making an informed, educated and supported choice. Every woman is entitled to it and if your Doctor won’t help but you want it, go to another Doctor.

Final thoughts

HRT is not a one-size-fits-all solution, but for many women, it can be life-changing. If you're considering HRT, speak with a menopause specialist or your GP to discuss your personal risks and benefits. The most important thing is to have accurate information so you can make the best decision for your health and well-being and this has been my aim with this blog.