Hormone therapy is the most effective treatment for menopausal symptoms such as hot flashes and night sweats. When started before age 60 or within ten years of menopause, overall mortality risk and heart attack risk do not increase, although the chances of stroke, blood clots, and with combined therapy also breast cancer, rise slightly. The balance is favorable for most women without contraindications, provided it is discussed with a doctor.
Hormone therapy does what it says on the tin: of all treatments for hot flushes, night sweats and other menopausal symptoms, it is by far the most effective. That is not a marginal advantage -- it is the best-supported option available.
The risk-benefit balance depends strongly on when you start. Starting before the age of 60 or within ten years of the menopause, large research (more than 44,000 women, 33 randomised trials) shows that overall mortality and the risk of a heart attack do not increase. Two risks do exist: the chance of a stroke and of blood clots rises slightly. With combined therapy using oestrogen and progestogen, the risk of breast cancer also increases somewhat with longer use. The form of delivery makes a difference here: patches or gel applied to the skin carry a lower clot risk than pills.
Who it is not suitable for: women with certain hormone-dependent cancers or a history of blood clots are generally excluded. These are personal factors to discuss with your GP or gynaecologist, who will also prescribe it and monitor its use. Available as a tablet, patch or gel, on prescription only.
In short: if your symptoms are seriously affecting your life and you start early in the menopause without the contraindications mentioned above, the balance is favourable for most women. The risks are real but modest, and weighing them up is precisely what a conversation with your doctor is for.
Strong evidence, based on 2 source(s), including controlled or causal research.