Hormone replacement therapy, better known as HRT, is one of the most talked-about (and sometimes misunderstood) options for managing menopause. For decades it has been both praised as a lifeline and criticised as a potential risk. The reality, as with many health decisions, is more nuanced. For some women, HRT can make an extraordinary difference in quality of life. For others, it may not be the best fit. So how do you know if it’s worth considering?
What Is HRT and How Does It Work?
HRT is designed to replace hormones that naturally decline during menopause. The two key players are oestrogen and progesterone. Oestrogen helps manage symptoms such as hot flushes, night sweats, vaginal dryness, and sleep disturbances. Progesterone is often added for women who still have a uterus, to protect against the risk of endometrial cancer. HRT comes in several forms — tablets, patches, gels, and vaginal treatments — which can be tailored to your needs and preferences.
Who Might Benefit Most?
HRT is most commonly recommended for women experiencing moderate-to-severe menopausal symptoms that significantly affect daily life. Hot flushes, night sweats, mood swings, or sleep disruption can all improve with hormone therapy. Women who experience early menopause (before age 45) or premature ovarian insufficiency may also benefit. According to Healthify NZ, replacing lost hormones at this stage can help relieve symptoms and protect long-term health, including bone density and cardiovascular wellbeing, until the average age of menopause. Ultimately, the decision isn’t about age alone — it’s about how symptoms impact your wellbeing.
Risks and Myths
No discussion of HRT is complete without addressing the concerns. Many women remember headlines from the early 2000s linking HRT to increased breast cancer risk. These fears stemmed from large studies that, while important, are now considered outdated in parts of their design and interpretation. More recent evidence shows the risks vary depending on the type of HRT, the dosage, and individual health factors. For many women under 60 or within 10 years of menopause, the benefits outweigh the risks. That doesn’t mean HRT is risk-free, but it does mean the conversation is more balanced than it once was.
Other Options
Not every woman can or wants to take HRT. Fortunately, there are other options. Non-hormonal treatments, such as certain antidepressants, can help with hot flushes and mood changes. Lifestyle changes also matter: staying active, limiting alcohol, maintaining a healthy weight, and managing stress can all make a difference. Some women turn to complementary therapies, though it’s important to discuss these with a doctor, as evidence for effectiveness is often limited.
Talking to Your Doctor
If you’re curious about HRT, the best first step is a conversation with your GP. Prepare a list of your symptoms, questions, and any concerns about family history or personal risk factors. A good consultation should feel like shared decision-making, where you and your doctor weigh the pros and cons together. There’s no one-size-fits-all answer, and the “right” decision may even change over time as your health and needs evolve.
Moving Forward
HRT isn’t for everyone, but for some women, it can be life-changing. Understanding how it works, who it helps most, and what the risks really are puts you in a stronger position to make the choice that’s right for you. Menopause may be a universal experience, but how you navigate it should be as individual as you are.
For more detailed, New Zealand–based information about HRT, visit Health Navigator NZ.