Education only · provider review required
Menopausal hormone therapy · What is approved, and what changed after 2002
The most-studied hormone treatment there is, and the most misunderstood.
Medically reviewed by Bernard Garcia, MD
What it is
Menopausal hormone therapy (MHT/HRT) uses oestrogen — with progesterone or a progestogen when a uterus is present — to treat menopausal symptoms. Many products are FDA-approved: patches, gels, sprays, oral tablets, vaginal preparations. Compounded "bioidentical" versions are also marketed, without the same regulatory review.
Fear of HRT dates from the 2002 Women's Health Initiative headlines; later analysis showed risk depends strongly on age at starting, time since menopause, dose and route. Professional societies now describe it as the most effective treatment for vasomotor symptoms in appropriately selected women.
How it works
Oestrogen relieves hot flushes, night sweats and genitourinary symptoms and protects bone; progestogen protects the uterine lining. Transdermal routes carry lower clot risk than oral. Contraindications include certain cancers, unexplained bleeding and clotting history — which is why a history and, often, imaging come first.
Research status
| Research area | Status |
|---|---|
| Vasomotor symptoms (hot flushes) | FDA-approved · strongest evidence |
| Genitourinary symptoms | FDA-approved (local oestrogen) |
| Bone protection | FDA-approved indication |
| Compounded "bioidentical" hormones | Not FDA-approved · under safety review |
Status reflects published research context only and is not a statement of safety, efficacy, or suitability for any person.
Is it legal?
FDA-approved HRT products carry labels and boxed warnings. Compounded bioidentical hormones are not FDA-approved and are the subject of an FDA/NASEM safety review. This is a general note, not medical advice.
Frequently asked questions
Is HRT safe?
For many women starting within ten years of menopause and under 60, benefits generally outweigh risks; for others they do not. A provider decides on your history.
Are compounded bioidentical hormones better?
There is no evidence they are safer or more effective than approved products, and their dosing is less consistent. FDA-approved products include bioidentical oestradiol and progesterone.
Does this page recommend HRT?
No. It explains what is approved and where the evidence stands.
Next step
Next step: a 3-minute confidential intake, reviewed by a licensed provider. No treatment is promised or implied.
Free · about 10 minutes · reviewed by a licensed physician
General education · Not medical advice · Provider approval required