What Is Hormone Replacement Therapy (HRT)?

Hormone Replacement Therapy (HRT), sometimes called menopausal hormone therapy, is a medical treatment that replaces the hormones your body makes less of during perimenopause and menopause—primarily estrogen, and sometimes progesterone and testosterone. It is one of the most effective ways to relieve moderate to severe menopause symptoms such as hot flashes and night sweats.

For many women, these shifting hormone levels can trigger life-disrupting symptoms: hot flashes, night sweats, vaginal dryness, brain fog, mood changes, weight gain, and trouble sleeping. HRT helps restore hormone levels to a range that reduces these symptoms and supports your overall quality of life, rather than “boosting” hormones above normal.

How Menopause Affects Your Hormones

As you approach menopause, your ovaries gradually produce less estrogen and progesterone. This transition happens in stages:

• Perimenopause – the years leading up to your final period; cycles become irregular and symptoms begin.
• Menopause – you’ve gone 12 months without a period.
• Postmenopause – the years after menopause, when low hormone levels are your new baseline.

Falling estrogen can affect temperature regulation, sleep, mood, vaginal tissue, urinary tract health, bones, and even your skin and hair, which is why symptoms can feel so widespread and frustrating. UpToDate³

What Exactly Does HRT Do?

HRT works by gently topping up the hormones your body no longer produces in the same amounts. Depending on your health history and symptoms, treatment may:

• Reduce hot flashes and night sweats
• Improve sleep quality
• Ease vaginal dryness and painful intercourse
• Help with urinary urgency or recurrent UTIs
• Support mood and cognitive function (such as brain fog)
• Help slow bone loss and reduce osteoporosis risk

These benefits are well documented in large clinical studies and reviews. Mayo Clinic²

The goal of HRT is not to give you “more” hormones than you had before, but to restore levels to a range that helps you feel better while staying as safe as possible.

Types of Hormone Replacement Therapy

There is no one-size-fits-all HRT. Your provider can customize the medication delivery type and dose of hormones based on your symptoms, medical history, and treatment goals.

1. Estrogen-Only Therapy

Estrogen-only therapy is typically used for women who no longer have a uterus (after hysterectomy). Estrogen can be given as a patch, pill, gel, spray, or vaginal ring and is especially effective for hot flashes, night sweats, and vaginal symptoms. The Menopause Society¹

2. Estrogen + Progesterone (or Progestin) Therapy

If you still have a uterus, progesterone (or a synthetic version called progestin) is added to protect the uterine lining from overgrowth caused by estrogen. This combination can be given as a pill, capsule, intrauterine device (IUD), or sometimes as a combination patch. UpToDate³

3. Local (Vaginal) Estrogen Therapy

Local estrogen therapy uses very low-dose estrogen applied directly to the vagina via creams, tablets, or a ring. It targets vaginal dryness, discomfort during sex, and some urinary symptoms. Because absorption into the bloodstream is minimal, this option may be safer for women who can’t use systemic estrogen. The Menopause Society¹

4. Other Hormones Sometimes Used

In some cases, other hormones may be used:

• Low-dose testosterone for certain women with low libido and persistent symptoms (off-label use in the U.S.).
• DHEA and compounded “bioidentical” hormones, which some clinics offer, though quality and dosing can be less predictable.

Major medical societies generally recommend using regulated, FDA-approved hormone products whenever possible to ensure consistent dosing and safety.

Important Disclaimer

The information provided here is for educational purposes only and should not be considered medical advice. Treatment must be personalized and supervised by a licensed healthcare professional.

Do not begin, change, or discontinue any hormone therapy without consulting your provider. For medical guidance specific to your health and hormone needs, please schedule an evaluation with a qualified practitioner.

1. The Menopause Society – Urogenital Health & Menopause Education
2. Mayo Clinic – Menopause Hormone Therapy: Risks, Benefits & Patient Guidance
3. UpToDate – Menopausal Hormone Therapy: Advanced Review & Considerations