Thinking About Menopause Hormone Therapy? Start Here.

On the flip side, in the last few years, a growing number of social media influencers and celebrities, like Oprah Winfrey, have loudly endorsed hormone therapy, presenting it as a “magic elixir,” Dr. Christmas said. “Now there’s this messaging that every woman who is menopausal should be on hormone therapy,” she said. But women need more clarity around what hormone therapy can and can’t do. “We’ve got to find our way back to the middle ground.” What is menopausal hormone therapy? Menopausal hormone therapy, or M.H.T., supplies some of the estrogen and progesterone lost in menopause. The Food and Drug Administration has approved dozens of types of therapies that have been shown to alleviate a narrow set of symptoms, including vasomotor symptoms — like hot flashes and night sweats — and genitourinary syndrome, which refers to painful sex, vaginal dryness and urinary tract infections. Hormone therapy can also be used to prevent postmenopausal bone loss. There are two broad categories of hormone treatment: systemic, in which the hormones can affect the whole body, and local, which are applied just to the vagina. Systemic treatments contain either estrogen alone or a combination of estrogen and progestogen (a synthetic version of progesterone), and come in the form of a pill, patch, gel, cream, spray or vaginal ring. They tackle hot flashes and night sweats, and can prevent osteoporosis. Systemic estrogen on its own can lead to the thickening of the uterine lining, which increases the risk of endometrial cancer, said Dr. Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health and medical director of the Menopause Society. Women who have had their uterus removed can safely use estrogen alone but others need to take some form of progestogen as well to counter its effects.