Managing Menopause with Hormonal Therapy: Pros and Cons

Menopause with Hormonal Therapy
Key takeaways:
  • Hormonal therapy can help with menopausal symptoms, but it’s not for everyone.
  • There are two types of hormonal therapy: estrogen-only and combination therapy.
  • Hormone therapy can be given as pills, patches, gels, sprays, creams, tablets, or rings.
  • Hormonal therapy may have risks, such as increased breast cancer and heart attack.
  • Women should discuss the risks and benefits with their healthcare provider and be monitored regularly.

Menopause is a phase of life that every woman goes through. However, the symptoms associated with it can be challenging to manage and affect the quality of life. One option for managing these symptoms is Hormonal Therapy. 

Hormonal therapy replaces the hormones the body no longer produces in the required amounts. While this treatment option can provide relief, one must carefully consider potential risks. 

Let’s explore the pros and cons of managing menopause with hormonal therapy to help women make informed decisions about their treatment options. 

Whether you are experiencing menopausal symptoms or want to learn more about hormonal therapy for women, read on to discover the key points to consider.

Hormonal Therapy or Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT) is a treatment that involves the use of hormones to alleviate the symptoms of menopause in women. Menopause is the discontinuation of reproductive ability in women, typically occurring between the ages of 45 and 55.

During menopause, a woman produces less estrogen and progesterone, which can cause uncomfortable symptoms, such as hot flashes, night sweats, vaginal dryness, and mood changes.

Menopausal hormone therapy (MHT) or hormone replacement therapy (HRT) involves taking either estrogen alone or a combination of estrogen and progesterone. Moreover, HRT can supplement the body’s declining hormone levels.

Types of Hormonal Therapy

There are two types of hormone therapy (HT) or hormone replacement therapy (HRT) for menopause:

Estrogen-only therapy

This type of therapy involves taking estrogen alone to alleviate the symptoms of menopause. Some women undergo a hysterectomy, which means surgical removal of the uterus. So, they usually do not require progesterone to safeguard against the risk of uterine cancer. Therefore, they are advised to discontinue progesterone therapy.

Combination hormone therapy:

Combination hormone therapy is recommended mainly for women who have not undergone a hysterectomy. It involves taking both estrogen and progesterone to alleviate menopausal symptoms. The use of progesterone in conjunction with estrogen is necessary to reduce the risk of endometrial cancer. 

The lining of the uterus, i.e. endometrium, is typically shed during menstruation in reproductive years. However, when menopause occurs, the endometrium no longer sheds, and estrogen can cause an overgrowth of cells in the uterus, leading to cancer.

Progesterone is essential in thinning the endometrium, thus reducing the likelihood of endometrial cancer. Hormone therapy with progesterone may result in monthly or no bleeding, depending on the type of therapy used. Continuous administration of progesterone and estrogen can reduce monthly bleeding and sometimes stop it entirely.

There are also different forms of hormone therapy, including:

  1. Oral: Hormones are taken in pill form.
  2. Transdermal: Hormones are absorbed through the skin via patches, gels, or sprays.
  3. Vaginal: Hormones are applied directly to the vaginal area via creams, tablets, or rings.

The choice of hormone therapy will depend on individual circumstances, including a woman’s medical history, current health status, and preferences. Before deciding, it is essential to consult a healthcare professional and examine each hormone therapy’s possible advantages and drawbacks.

Pros of Hormonal Therapy

Hormone replacement therapy (HRT), can provide several benefits for women experiencing symptoms of menopause. Here are some of the pros of hormonal treatment for menopause:

Relieves hot flashes: 

Hot flashes are among the prevalent and inconvenient symptoms experienced during menopause. Hormonal therapy can help reduce the frequency and severity of these symptoms, improving a woman’s overall quality of life.

Helps with vaginal dryness: 

Menopause can cause vaginal dryness, which can, in turn, lead to discomfort during sexual intercourse. The therapy can help restore vaginal moisture and elasticity, reducing discomfort and pain during intercourse.

Improves bone health: 

Menopause can increase the risk of osteoporosis. It is a condition that weakens bones and makes them more prone to fractures. Hormonal replacement therapy can help improve bone density and reduce the risk of fractures.

Helps with mood changes: 

Menopause can also cause mood changes, including irritability, anxiety, and depression. Hormonal replacement therapy can help improve mood and reduce the risk of developing depression.

Reduces the risk of colon cancer: 

Hormonal therapy reduces the risk of colon cancer in postmenopausal women. These are some of the critical benefits of hormonal therapy for menopause. However, it’s important to note that every woman’s experience with menopause is different, and the benefits of hormonal treatment may vary depending on the individual. Additionally, you should carefully consider potential risks associated with hormonal therapy before starting treatment.

Cons of Hormonal Therapy

While hormonal therapy for menopause can relieve symptoms and improve overall health, there are also potential risks and side effects to consider. Here are some of the cons of therapy for menopause:

Increased risk of breast cancer: 

Hormonal therapy has been associated with an increased risk of breast cancer, particularly long-term use. Women with a background of breast cancer or other risk factors for breast cancer may not be good candidates for the therapy.

Increased risk of blood clots: 

Hormone therapy can increase the risk of blood clots, leading to serious health problems like stroke or heart attack.

Risk of heart disease: 

Hormonal therapy has been linked to an increased risk of heart disease, particularly in older women or those with other risk factors for heart disease.

Side effects: 

Hormonal replacement therapy can cause side effects like bloating, breast tenderness, headaches, and nausea.

Increased chance of gallbladder/gallstone problems: 

Hormone therapy (HT) can increase the risk of gallbladder problems, including the development of gallstones. Estrogen, a hormone commonly used in HT, can cause the gallbladder to contract less frequently, leading to the formation of gallstones. Estrogen also increases the cholesterol level in the bile, which can contribute to gallstone formation.


Hormone replacement therapy (HRT) or hormone therapy (HT) can be an effective treatment option for women experiencing menopausal symptoms such as night sweats and vaginal dryness. However, the decision to use HRT should be made individually after weighing the potential risks and benefits and discussing them with a healthcare provider. Women who have had a hysterectomy may be candidates for estrogen-only therapy. In contrast, women without a hysterectomy may be candidates for combination therapy, including estrogen and progesterone. Different methods, including oral pills, transdermal patches, gels, sprays, vaginal creams, tablets, or rings are the ways to deliver hormones.

It’s important to note that HRT may be associated with certain health risks, including an increased risk of breast cancer, blood clots, and stroke. Women considering hormone therapy should discuss their medical history and current health status with their healthcare provider to determine if it’s a safe and appropriate treatment option. Healthcare providers should regularly monitor women who decide to use HRT. Such an approach assesses their response to treatment and any potential side effects.