Hormone replacement therapy for women, individualized and evidence-based

Who may benefit

Hormone therapy is the most effective treatment for hot flashes and night sweats and also prevents bone loss. It may be appropriate for women with bothersome symptoms who are under 60 or within about 10 years of menopause and who do not have contraindications such as certain cancers, prior blood clots or stroke.

Forms of hormone therapy

Your prescription is chosen around your health history and preferences. Options can include:

• Transdermal estradiol (patch, gel or spray), which does not appear to raise clot risk the way oral estrogen can
• Oral estradiol
• Micronized progesterone, needed to protect the uterine lining if you have a uterus
• Low-dose vaginal estrogen for genitourinary symptoms

About 'bioidentical' hormones

Many FDA-approved products, including estradiol and micronized progesterone, are chemically identical to the hormones your body makes. Unpaused generally favors FDA-approved, regulated products. Custom-compounded hormone pellets and creams are not FDA-approved, and The Menopause Society advises against their routine use when an approved option is available.

Ongoing monitoring

Hormone therapy is not set-and-forget. Follow-up visits review how you feel, side effects, bleeding patterns, blood pressure and preventive screening, and doses are adjusted when clinically appropriate.