Benefits and risks of hormone replacement therapy (HRT)

The benefits of hormone replacement therapy (HRT) usually outweigh the risks. Recent evidence says that the risks of serious side effects from HRT are very low.

Older studies found potential risks of HRT, and made many people reluctant to take or prescribe it. But this view is now seen as out of date because it does not take account of the benefits as well as the risks.

The benefits and risks of taking HRT depend on your age, your menopause symptoms and any risk factors you have.

If you're under 60 years old, have menopause symptoms, and are not at high risk of breast cancer or blood clots, the benefits of HRT are likely to outweigh the risks.

Talk to a GP, who will help you decide.

Read more about when to take HRT and how long to take it for

Benefits of HRT

Relieving menopause symptoms

The main benefit of HRT is that it's effective at relieving most perimenopause and menopause symptoms, such as:

• hot flushes
• night sweats
• sleep problems caused by menopause
• anxiety and low mood caused by menopause
• vaginal dryness

You should find that your symptoms improve after a few days or weeks of taking HRT.

Preventing osteoporosis

Osteoporosis is thinning of the bones, which makes you more likely to have a fracture. It's common after the menopause because your level of oestrogen falls. Oestrogen is needed for healthy bones.

HRT helps to prevent osteoporosis by increasing your level of oestrogen.

It's particularly important to take HRT to help prevent osteoporosis if your periods stop before the age of 45 (early menopause).

Maintaining muscle strength

It's common to lose muscle strength as you reach menopause. HRT can improve this and help your muscles stay strong. It's also important to exercise to keep your muscles strong.

Risks of HRT

The risks of any serious side effects are usually very low, and depend on the type of HRT you take, how long you take it and your own health risks.

Breast cancer

HRT can slightly increase the risk of breast cancer. If you've had breast cancer you'll usually be advised not to take HRT.

The increased risk is low: there are around 5 extra cases of breast cancer in every 1,000 women who take combined HRT for 5 years.

The risk increases the longer you take it, and the older you are. It falls again after you stop taking it.

There is little or no increase in the risk of breast cancer from oestrogen-only HRT, which you can take if you've had a hysterectomy to remove your womb.

You can reduce the risk of breast cancer by not taking HRT for longer than you need it to control your symptoms. Find out more about when to take HRT.

There are also lifestyle changes that can reduce the risk of breast cancer.

Blood clots

HRT tablets can increase the risk of blood clots, but the risk is still very low.

HRT patches, sprays and gels do not increase the risk of blood clots. This is because oestrogen is safer when it's absorbed into your body through your skin.

If you're at risk of blood clots you'll usually be advised to use HRT patches, spray or gel rather than tablets.

Stroke

HRT tablets (but not patches, gel or spray) slightly increase the risk of stroke. But the risk is still very low, particularly if you're under 60 years old.

Research into HRT and other conditions

Research has shown that taking HRT has little or no effect on the risk of getting coronary heart disease.

More research is being done to find out how taking HRT affects some other conditions, such as dementia and diabetes. Any increased risk or benefit is likely to be small.

It's not known whether HRT reduces the risk of dementia.

HRT does not increase the risk of developing type 2 diabetes. Some recent studies have suggested that it may even slightly reduce the risk.

Benefits and risks of vaginal oestrogen

Vaginal oestrogen helps with vaginal dryness. It does not increase the risk of breast cancer, blood clots or other conditions.

The dose is low and very little of the medicine gets into the rest of your body, so it's safe to use it for a long time.