Is hormone therapy safe for menopause?

Written and medically reviewed by Stacy Silverman, MSN, APRN, FNP-BC · Published October 4, 2026 · Last reviewed October 4, 2026

For most healthy women under 60 or within 10 years of menopause who have bothersome symptoms, The Menopause Society concludes the benefits of hormone therapy generally outweigh the risks. Safety depends on your age, timing, health history, and the type, dose and route of hormones used.

What happened in 2002

Early results from the Women's Health Initiative (WHI) reported increased risks of breast cancer, heart disease, stroke and blood clots, and hormone use dropped sharply. The average participant, however, was 63 and many were more than a decade past menopause. Later analyses by age showed a much more favorable picture for women who start closer to menopause.

Risks to understand

Hormone therapy is not risk-free. Important considerations include:

Oral estrogen slightly increases the risk of blood clots and stroke; transdermal estrogen appears to carry lower clot risk
Combined estrogen-plus-progestogen therapy is associated with a small increase in breast cancer risk with longer use
Women with a uterus need progesterone to protect the uterine lining
Hormone therapy is generally not recommended for women with a history of breast cancer, blood clots, stroke or active liver disease

Benefits

Hormone therapy is the most effective treatment for hot flashes and night sweats, improves genitourinary symptoms, and helps prevent osteoporosis-related fractures. Many women also report better sleep and quality of life.

The bottom line

Safety is individual. The right decision comes from a careful review of your symptoms, personal and family history, and preferences, with periodic reassessment over time.

Learn how we approach this in Hormone Therapy (HRT).

Sources

This article is for education only and is not a substitute for individual medical advice.