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What to know about hormone replacement therapy (HRT)

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What is HRT?HRT typesHRT side effectsContacting a doctorSummary
Hormone replacement therapy (HRT) can effectively manage hormonal imbalances and enhance your well-being, but it is important to understand its effects.
Medically reviewed by Megan Soliman, MD
Written by Charlotte Parker
Updated on

Hormone replacement therapy (HRT) is a medical treatment aimed at alleviating symptoms hormonal imbalances or deficiencies can cause.

It involves supplementing your body’s hormones to restore their optimal levels and alleviate symptoms like hot flashes, shifts in mood, and energy loss.

What is HRT?

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HRT covers a range of treatments. For females, HRT usually involves taking estrogen or a mix of estrogen and another hormone called progesterone. For males, HRT typically means getting testosterone.

You can take HRT in different ways, including pills, skin patches, gels, or shots, depending on your needs or preferences.

Signs you may need hormone replacement therapy (HRT)

If you’re wondering whether you might need HRT and what signs to look for, understanding the signs and symptoms associated with hormonal imbalances, such as the following, can indicate a need for HRT.

Below is a list of key signs and symptoms to help you determine if HRT might be beneficial for you:

  • Hot flashes and night sweats: These are often linked to declining estrogen levels in women undergoing menopause or perimenopause.
  • Vaginal dryness and discomfort: This happens as a result of reduced estrogen, affecting the moisture and elasticity of vaginal tissues.
  • Irritability and shifts in mood: Fluctuations in estrogen and testosterone levels in females and males, respectively, can cause irritability and shifts in mood.
  • Sleep disturbances: These are common in menopausal people and are related to decreasing estrogen levels.
  • Decreased bone density: Lower estrogen levels in females and testosterone in males can lead to a decrease in bone density (osteoporosis).
  • Decreased libido: This is linked to reduced estrogen in females and testosterone in males.
  • Fatigue and decreased energy levels: In males, this may indicate low testosterone levels.
  • Loss of muscle mass and strength: Testosterone is key for maintaining muscle mass in males.

Recognizing these symptoms can help guide discussions with a healthcare professional regarding the possibility and appropriateness of HRT.

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HRT types

There are various types of Food and Drug Administration (FDA)-approved hormone replacement therapies, each tailored to address specific needs based on your gender, hormonal deficiencies, and individual health conditions.

For females

  • Estrogen-only HRT: This addresses menopausal symptoms and bone density loss, particularly for those post-hysterectomy.
  • Combined HRT: This combines estrogen and progesterone to help ease menopause symptoms and reduce endometrial cancer risk for females with uteruses.
  • Cyclical HRT: This is a blend of continuous estrogen with cyclical progesterone for perimenopausal women or those with irregular cycles.
  • Continuous combined HRT: This provides daily estrogen and progesterone for postmenopausal symptom management and bone protection.
  • Local estrogen therapy: This is a direct application for vaginal symptoms that the body only minimally absorbs.

For males

Testosterone replacement therapy (TRT) treats low testosterone symptoms like reduced libido and muscle mass.

For both males and females:

The choice of HRT type depends on various factors, including your specific health needs, hormonal imbalances, symptoms, and potential risks.

While some forms of testosterone therapy and local estrogen treatments are FDA approved, their use, particularly testosterone therapy for women with low libido or energy, is not universally approved.

However, doctors might sometimes prescribe them off-label. This means the FDA approves the drug for one purpose, but a doctor or another healthcare professional may prescribe it for another.

HRT side effects

Understanding the various potential side effects and risks HRT types can lead to is important for making informed health decisions. The table below shows the possible side effects and risks.

TypeSide effectsRisks
estrogen-only HRT nausea, bloating, breast tendernessincreased risk of uterine cancer
combined HRT (estrogen + progesterone)shifts in mood, weight gain, headachesslightly increased risk of breast cancer
cyclical or sequential HRTmenstrual-like bleeding, breast tenderness, mood fluctuationssimilar to other forms of estrogen-progesterone therapy
continuous combined HRTsimilar to combined HRT

may reduce menstrual bleeding
comparable to combined HRT, including the risk of breast cancer
local estrogen therapyvaginal irritation or dischargelower risk compared to systemic therapies but requires monitoring
testosterone therapy (including TRT)acne, increased body hair, shifts in mood, cholesterol changespotential risk of cardiac events and prostate cancer

Discussing these potential side effects and risks with a healthcare professional is crucial to ensuring you get the right care.

Discussing options with a healthcare professional

Discussing HRT options with a healthcare professional is essential for ensuring your treatment plan is tailored to your individual needs, health status, and personal preferences.

Here are some key points to consider and discuss during your consultation:

  • symptoms: sharing details about your symptoms and their impact on your life
  • medical history: discussing past health issues, surgeries, and family health history
  • lifestyle: mentioning your diet, physical activity level, and behaviors like smoking (if you do) or drinking (if you do)
  • HRT options: asking about different HRT types and their pros and cons
  • methods: exploring HRT delivery methods, such as pills or patches, to discover what suits you best
  • risks: understanding the possible side effects and risks of HRT
  • monitoring: talking about how your treatment will be tracked and adjusted
  • alternatives: inquiring about non-HRT options for symptom management
  • decision-making: participating in decision-making about your treatment plan
  • informed consent: ensuring you are fully informed about HRT benefits and risks

A thorough and open discussion with a healthcare team can help you make an informed choice about HRT.


HRT offers a valuable solution for managing the challenging symptoms associated with hormonal imbalances.

Working closely with a healthcare team can help you navigate available options to find a treatment plan that reduces your risk of side effects and is tailored to your individual needs.

Many people find significant relief and a renewed sense of well-being with the right approach. Remember, HRT aims to help you lead a more comfortable and fulfilling life.

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