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Benefits and risks - Hormone replacement therapy (HRT)

When deciding whether to have hormone replacement therapy (HRT), it's important to understand the benefits and risks.

Many studies on HRT published over the past 15 years highlight the potential risks. As a result, some women and doctors have been reluctant to use HRT.

But recent evidence says that the risks of HRT are small and are usually outweighed by the benefits.

Benefits of HRT

The main benefit of HRT is that it can help relieve most menopausal symptoms, such as:

  • hot flushes
  • night sweats
  • mood swings
  • vaginal dryness
  • reduced sex drive

HRT can also help prevent thinning of the bones, which can lead to fracture (osteoporosis). Osteoporosis is more common after the menopause.

Risks of HRT

The benefits of HRT usually outweigh the risks for most women.

The risks are usually very small, and depend on the type of HRT you take, how long you take it and your own health risks.

Speak to a GP if you're thinking about starting HRT or you're already taking it, and you're worried about any risks.

Breast cancer

There is little or no change in the risk of breast cancer if you take oestrogen-only HRT.

Combined HRT can be associated with a small increase in the risk of breast cancer.

The increased risk is related to how long you take HRT, and it falls after you stop taking it.

Because of the risk of breast cancer, it's especially important to attend all your breast cancer screening appointments if you're taking HRT.

Blood clots

The evidence shows that:

  • there's no increased risk of blood clots from HRT patches or gels
  • taking HRT tablets can increase your risk of blood clots - but this risk is still small

Heart disease and strokes

HRT does not significantly increase the risk of cardiovascular disease (including heart disease and strokes) when started before 60 years of age, and may reduce your risk.

Taking HRT tablets is associated with a small increase in the risk of stroke, but the risk of stroke for women under age 60 is generally very low, so the overall risk is still small.

Page last reviewed: 09 September 2019
Next review due: 09 September 2022