Can HRT help with weight gain?

Many women notice changes in their weight and body shape during menopause, particularly around the abdomen. While HRT isn't a weight loss treatment, it may help counter some of the hormonal changes that contribute to weight gain. Want specific weight loss support? Voy can help with that, too.

At what age is HRT most effective?

HRT tends to offer the greatest benefits when started around the time of menopause, typically in the late 40s or early 50s. However, there is no "perfect" age to start, and many women benefit from HRT later if menopausal symptoms are affecting their quality of life.

Does HRT help with belly fat?

HRT may help to some extent with the shift in fat distribution that often happens during menopause, when weight is more likely to settle around the middle. However, regular exercise and a balanced diet, or weight-loss treatments, are more effective approaches for treating excess belly fat.

Does HRT really make you look younger?

Some women notice improvements in their skin's hydration, texture and elasticity after starting HRT because oestrogen helps support collagen production.

Is HRT safer now than it used to be?

In many ways, yes. Modern HRT often uses body-identical hormones and transdermal options such as patches and gels, which have a more favourable safety profile than some older treatments.

Are HRT patches safe?

For most women, yes. HRT patches are considered one of the safest ways to take oestrogen because they deliver it through the skin, avoiding some of the risks associated with tablets.

How long is it safe to take HRT?

There is no set time limit for taking HRT. As long as the benefits continue to outweigh the risks for you, and you have regular reviews with your healthcare professional, it can be continued for many years if needed.

What are the risks of HRT after 70?

HRT can still be appropriate in your 70s, but the balance of benefits and risks becomes more individual. Factors such as your overall health, medical history and the type of HRT you're using will all influence whether it remains the right option for you.

Yes. HRT gel delivers oestrogen through the skin, giving it a similar safety profile to patches and avoiding the increased clotting risk associated with oral oestrogen.

Is it safe to take HRT after menopause?

Yes. Many women continue HRT well beyond menopause to manage symptoms, support bone health, or improve quality of life, and there is no automatic age at which it must be stopped.

Is it safe to stop HRT suddenly?

Stopping HRT suddenly isn't usually dangerous, but it can cause menopausal symptoms such as hot flushes and sleep problems to return quite quickly. It’s usually more comfortable to reduce your dose gradually with guidance from a healthcare professional.

Is it safe to take evening primrose oil with HRT?

There are no well-established interactions between evening primrose oil and HRT, and many women use them together without problems. But it's always worth mentioning any supplements you're taking to your doctor, particularly if you take other medications.

Pros and Cons of HRT: Benefits, Risks, and Safety Explained

If you're considering HRT, you've probably come across mixed messages. Perhaps a friend describes it as life-changing for her, but news stories or conversations from years ago have left you worried about the potential risks. It's no wonder many women feel uncertain about what to believe.

The reassuring news is that our understanding of HRT has evolved significantly. Here’s what we know now.

Key takeaways

For most healthy women experiencing menopausal symptoms, the benefits of HRT outweigh the risks.
HRT is the most effective treatment for menopausal symptoms.
HRT also protects against several health conditions that become more common after menopause.
There is no increase in the risk of breast cancer from using body-identical HRT.
Deciding on HRT is a personal decision, and your doctor will take your health history, lifestyle and preferences into account.

Is HRT safe?

The most important thing to know is that HRT is the most effective treatment for perimenopausal and menopausal symptoms. And for most women, the benefits usually outweigh the risks.

That said, deciding whether to take HRT is a personal decision, and it’s not the best option for everyone. But for healthy women experiencing menopausal symptoms, it is a well-evidenced, widely recommended treatment.

What are the benefits of HRT?

HRT stands for hormone replacement therapy. During perimenopause and menopause, levels of hormones such as oestrogen and progesterone begin to fluctuate and gradually decline. This can lead to symptoms like hot flushes, night sweats, low mood, sleep problems and vaginal dryness. HRT works by replacing these hormones, helping to restore them to more stable levels and reduce symptoms.

HRT benefits include not just relief from the immediate symptoms of menopause, but also longer-term protection against certain health conditions.

Menopause symptom relief

HRT works by replacing the hormones your body produces less of in the lead-up to menopause. The symptoms it’s most effective for include:

Hot flushes and night sweats: Often called “vasomotor symptoms” by doctors, these affect around three-quarters of women during menopause. They can be disruptive and exhausting, but HRT is highly effective at reducing both how often they occur and how intense they feel.
Sleep problems: Whether it's being woken by night sweats or the direct effects of changing hormone levels, many women find their sleep suffers during menopause. HRT can often lead to deeper, more restful sleep and help you feel more like yourself again.
Mood changes: Feeling more anxious, irritable or emotionally up and down is common during perimenopause and menopause. By helping to smooth out hormonal fluctuations, HRT can improve your mood and emotional wellbeing.
Brain fog and concentration difficulties: Many women describe struggling to focus, feeling forgetful or finding it harder to think clearly. HRT can often help improve mental clarity and concentration.
Vaginal and urinary symptoms: Menopause can cause vaginal dryness, discomfort during sex and urinary symptoms such as urgency or recurrent infections. HRT can help restore comfort and improve quality of life.
Joint and muscle aches: Aching joints and stiffness are common but often overlooked menopause symptoms. Many women notice these symptoms ease once they start HRT.
Low sex drive: Changes in hormones can affect libido during menopause. Many women find that HRT helps them feel more interested in sex again.

Not sure what’s normal anymore?

When you're experiencing new symptoms, it can be hard to know what’s part of menopause and what’s not. You deserve care that looks at the full picture.

Longer-term health benefits

As well as relieving menopausal symptoms, HRT has established protective effects on several conditions that become more common after menopause:

Maintained muscle strength: It's common to lose muscle strength as you reach menopause. HRT can help you with daily functioning as you age.
Improved bone health: Oestrogen plays a critical role in maintaining healthy bones. After menopause, women lose bone faster, increasing the risk of osteoporosis and fractures. HRT helps to prevent these conditions by increasing oestrogen levels.
Cardiovascular protection: Oestrogen helps protect your heart and keep your blood vessels healthy. Research shows that starting HRT within 10 years of menopause or before age 60 can reduce your risk of developing coronary heart disease, or of having a heart attack and stroke.

Benefits of HRT after 50, 60 and 65

Age is one of several factors your doctor will consider when discussing whether HRT is right for you.

When prescribed before the age of 60 (or up to ten years post-menopause), HRT generally offers more benefits than risks, including helping to protect bone health and supporting cardiovascular health.

Starting HRT in your 60s can be a little more complex. The heart-health benefits are less clear if you’re more than 10 years past menopause, and the risk of many health conditions increases with age, regardless of whether you take HRT. But many women continue or start HRT after 60 to manage symptoms, protect their bones or maintain their quality of life.

What are the risks of HRT?

Like any medication, HRT has potential risks as well as benefits. Factors such as your age, medical history, family history and the type of HRT prescribed can all influence your overall risk profile.

Breast cancer

The risk most often discussed in relation to HRT is breast cancer. Much of the concern stems from studies published more than 20 years ago, which led to widespread fears about HRT. Since then, researchers have gained a much clearer understanding of the risks and benefits.

It's important to know that newer studies on body-identical HRT, which contains oestrogen and micronised progesterone, have not found an increased risk of breast cancer (based on five years of clinical data).

There is also no increase in the risk of breast cancer from oestrogen-only HRT, which you can take if you've had a hysterectomy to remove your womb.

Some types of combined HRT (which contains both oestrogen and synthetic progestogen) are associated with a small increase in breast cancer risk, but it's important to understand what that means in real-world terms. For most women, the additional risk is similar to that associated with lifestyle factors such as drinking one to two units of alcohol a day or being overweight.

Blood clots

Oestrogen HRT tablets can slightly increase your risk of blood clots, but that risk is still very low. HRT patches, sprays and gels do not increase the risk of blood clots because oestrogen is safer when absorbed through your skin. Vaginal oestrogen (used to treat vaginal dryness or urinary symptoms) doesn’t increase the risk of blood clots either.

Who should avoid or take extra care with HRT?

HRT isn't the right choice for everyone, and it's perfectly okay if you decide it's not for you. Many women manage their menopause symptoms successfully with other approaches, such as non-hormonal medications, lifestyle changes or menopause supplements.

Your doctor can help you weigh up the potential benefits and risks. They might recommend alternatives to HRT, or suggest specialist advice, if you have:

A personal history of breast cancer, particularly oestrogen receptor-positive breast cancer
A personal history of womb (endometrial) cancer
Unexplained vaginal bleeding that hasn't yet been investigated
Untreated high blood pressure
An active or recent history of blood clots
Active liver disease

Being told that HRT isn't suitable for you can feel incredibly disappointing, especially if menopausal symptoms are affecting your quality of life. While a history of breast cancer or certain other health conditions can make the decision more complex, it doesn't always mean that HRT is automatically ruled out.

At Voy, you'll have access to clinicians with expertise in breast cancer and menopause, who can take the time to review your individual circumstances, discuss the latest evidence, and help you understand the options available to you. Rather than a one-size-fits-all approach, you'll receive personalised guidance.

What can help reduce HRT risks?

If you decide HRT is right for you, there are several ways to help ensure it's as safe and effective as possible:

Be open about your medical history: Sharing your personal and family health history helps your clinician recommend the safest and most suitable treatment for you.
Choose the most appropriate type of HRT: If you have a womb, body-identical (micronised) progesterone is often preferred because it appears to carry a lower risk of complications and side effects than some synthetic progestogens. Your doctor will advise you on the safest choices.
Have regular check-ins: Menopause symptoms and health needs can change over time. Regular reviews with your clinician allow your treatment to be adjusted if needed and help ensure the benefits continue to outweigh any risks.
Look after your overall health: Not smoking, staying active, maintaining a healthy weight and eating a balanced diet can all help reduce the background health risks that become more important as we age.

Should you take HRT?

HRT can be a game-changer for menopause symptoms, but there is no single answer to the question “Do I need HRT?” The right decision depends on many factors, including your symptoms, your age, your personal and family medical history, the type of HRT being considered and, importantly, how you feel about the potential benefits and risks.

If you're unsure, you're not alone. Many women find it helpful to talk through their options with a menopause specialist who can provide personalised advice based on their individual circumstances.

Want tailored guidance based on your symptoms and health history? Voy's menopause specialists can help you understand your options and find an approach that feels right for you. Book a consultation today.

The pros and cons of HRT