Hormone Replacement Therapy: What It Is and What to Expect
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Hormone Replacement Therapy?
An ob-gyn, a doctor who treats women's health, can talk with you about hormone therapy for menopause. The information below covers hormone therapy for menopause. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Menopause is the time in a woman's life when her periods stop. In menopause, the body makes much less of the hormones estrogen and progesterone. Hormone therapy involves taking estrogen. Sometimes progesterone or a similar hormone called progestin is added. The goal is to replace some of the hormones the body no longer makes and help relieve menopausal symptoms. It is also called hormone replacement therapy, or HRT.
Why a doctor might recommend it
Low hormone levels in menopause can cause hot flashes, night sweats, mood changes, vaginal dryness, and pain during sex. Hormone therapy may help relieve these symptoms. It may also help protect against osteoporosis, a condition of thin bones that break more easily. Systemic estrogen therapy sends estrogen through the blood. It has been shown to be the best treatment for hot flashes and night sweats.
How to prepare
These steps may help you get ready.
- Talk with your provider about your medical history before you start.
- You and your provider should talk about the risks and benefits.
- Hormone therapy is not right for everyone.
What happens during it
Hormone therapy for menopause comes in several forms. Most are pills taken by mouth. There are also skin patches, gels or sprays, vaginal creams, tablets, or rings. Systemic estrogen goes into the blood and travels to the organs and tissues where it is needed. Local estrogen is a vaginal ring, tablet, or cream.
If you had a hysterectomy, you may take estrogen only. A hysterectomy is surgery to remove the uterus. If you still have your uterus, you also will need progestin. Progestin helps lower the risk of uterine cancer, which can happen when estrogen is used alone.
Recovery
Many providers suggest checking in every three to six months at first. Then once a year is common. Side effects can include vaginal spotting, sore breasts, bloating, and headaches. Talk with your ob-gyn if these side effects trouble you or last longer than expected.
Risks and side effects
For some women, hormone therapy may raise the risk of blood clots, heart attack, stroke, breast cancer, and gallbladder disease. The risk depends on the type of hormone therapy, how long you use it, and your health and lifestyle. Estrogen alone thickens the lining of the uterus. This raises the risk of endometrial cancer. Adding progestin lowers this risk. Combined hormone therapy is linked to a small rise in breast cancer risk. Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, sudden weakness or change in vision, trouble speaking, coughing up or vomiting blood, or bleeding that will not stop.
Who performs it
Your health care provider can help you choose the type and form of hormone therapy that is best for you.
Common questions
Who should not use hormone therapy for menopause?
You should not use it if you are pregnant or think you may be pregnant. Other reasons are unexplained vaginal bleeding, some cancers, a past stroke or heart attack, blood clots, or liver disease.
How long do people take hormone therapy?
It depends on your symptoms, risks, and benefits. You and your ob-gyn should talk every year about whether to continue. It is usually recommended to use the lowest dose that helps and for the shortest time needed.
Are bioidentical hormones safer?
There is no scientific evidence that compounded hormones, sometimes called bioidentical hormones, are safer or work better than standard hormone therapy. The FDA does not regulate compounded drugs, and they can vary in strength and purity. Claims that they are safer or more natural are not backed by credible science.
What can I use instead of hormone therapy?
You can use over-the-counter vaginal moisturizers and lubricants. Nonhormonal medicines can help too. Antidepressants can relieve hot flashes. Few plant and herbal supplements have been studied for safety or effectiveness.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
Sources
- MedlinePlus - Hormone Therapy for Menopause
- American College of Obstetricians and Gynecologists - Hormone Therapy for Menopause
- National Cancer Institute - Menopausal Hormone Therapy and Cancer
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
