Recent media buzz highlights the benefits of hormone replacement therapy – or HRT – for perimenopausal women. And it’s true; experts now say for women within the first ten years of becoming menopausal, the benefits of HRT outweigh previously found risks.
HRT replaces the female hormones women naturally lose in their bodies as they go through menopause. “Unfortunately, research sent mixed messages regarding HRT over the past several decades,” says Diane Maddela, DO , an OB/GYN at Riverside Partner’s in Women’s Health. A Riverside Health Systems expert shares the latest research, so you can decide if this treatment may be right for you.
Latest research on HRT for younger menopausal women
In 2002, the first results of the Women’s Health Initiative (WHI) from the National Institutes of Health (NIH) found that HRT had more harmful than beneficial effects for menopausal women. The study found that using estrogen plus progesterone hormones after menopause increased a woman’s risk for heart disease, stroke, blood clots, breast cancer and dementia. These alarming findings led to a 46% decline in the number of women using HRT in the United States.
However, experts today argue the study may have created too much fear and was misleading about the impact of taking HRT for perimenopausal women. “More recent studies have found that HRT is a safe, effective treatment to reduce menopause symptoms in healthy women under the age of 60” explains Dr. Maddela “although age will vary for many women, and may even go past 60 for some, the key beginning HRT within the first 10 years of the last menstrual period”.
In conjunction with new research, multiple re-analyses of the above WHI study have found benefits to using HRT in women aged 50-59 and in their first 10 years of menopause. These benefits include reducing the chance of heart disease and death.
Candidates for HRT Today, experts say that HRT is beneficial and safe for women in the following stages:
- Premature menopause (last menstrual period before age 40)
- Early menopause (last menstrual period between ages 40 and 45)
- Menopause (last menstrual period after 45 but before 60)
HRT menopause symptom relief
The primary reason women use HRT is to get relief from many bothersome menopause symptoms, including:
- Decreased sex drive
- Hot flashes
- Itchy skin
- Joint pain
- Night sweats
- Trouble sleeping
- Vaginal dryness
Long-term benefits of HRT
In addition to helping women find relief from many menopausal symptoms, research has identified several longer-term benefits of HRT. “In general, experts suggest that women begin hormone therapy within 10 years of their last menstrual period,” says Dr. Maddela. When taken as recommended and prescribed, HRT may help to reduce women’s risks of the following health conditions:
- Cardiovascular disease
- Dementia
- Endometrial cancer (when women take estrogen in combination with progesterone)
- Osteoporosis
- Parkinson’s disease
- Type 2 diabetes
Because experts have now determined these health benefits outweigh any risks for women beginning hormone therapy within 10 years of their last menstrual period, this age group should feel more comfortable taking advantage of the benefits HRT can offer.
Reducing your risks while taking HRT
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If you’re taking HRT to manage symptoms of menopause or provide protection against the health conditions listed above, you may still worry about potential risks. Here are some ways you can help keep yourself as healthy as possible while taking HRT:
• Work with a specialist to find the best product and delivery method – such as pill, patch or gel – for you
• Maintain a healthy lifestyle, including:- Avoid smoking and other tobacco products
- Get regular physical activity
- Keep a healthy body weight
- Limit your alcohol intake
- Manage your chronic health conditions
- Manage your stress
- See your doctor for ongoing monitoring
- Take the lowest effective dose
Get care now
If you are in menopause or are starting to experience early menopause symptoms, schedule an appointment with your OB/GYN or primary care doctor. They can help you understand what to expect, what’s normal and how to handle bothersome symptoms.
Additional references
Baber RJ, Panay N, Fenton A, IMS Writing Group 2016, ‘2016 IMS recommendations on women's midlife health and menopause hormone therapy’,
Climacteric, vol. 19, no. 2, pp. 109–50. Martin KA, et al. Treatment of menopausal symptoms with hormone therapy.
Stuenkel CA, Davis SR, Gompel A et al. 2015, ‘Treatment of symptoms of the menopause: an endocrine society clinical practice guideline’, Journal of Clinical Endocrinology and Metabolism vol. 100, no. 11, pp. 3975–4011.
The 2022 hormone therapy position statement of The North American Menopause Society, 2022, Menopause, vol. 29, no. 7, pp. 767-794.
