What is hormone replacement therapy (HRT)?

Bottom lineHormone replacement therapy (HRT) replaces the estrogen (and usually progesterone) the body makes less of in perimenopause and menopause, and is the most effective treatment for hot flashes, night sweats, vaginal dryness, and sleep and mood symptoms, while protecting bone. Estrogen comes as tablets, patches, gels, or sprays, with progesterone added if you have a uterus; it's safe and effective for most when started around menopause, with risks depending on type, dose, route, age, and health.

Hormone replacement therapy (HRT), also called menopausal hormone therapy, replaces the estrogen (and usually progesterone) your body makes less of during perimenopause and menopause. It's the most effective treatment for many menopausal symptoms.

What it treats

• Hot flashes and night sweats (most effective treatment)
• Vaginal dryness and discomfort during sex
• Sleep and mood symptoms
• Helps protect against bone loss (osteoporosis)

The main types

• Estrogen - the key symptom-reliever, as a tablet, patch, gel, or spray
• Progesterone/progestogen - added if you still have a uterus, to protect the womb lining from estrogen
• Vaginal estrogen - a low-dose local option specifically for vaginal dryness and urinary symptoms, with minimal whole-body absorption

Benefits and risks

HRT is safe and effective for most people, especially when started around the time of menopause. Risks (such as small changes in breast cancer or clot risk) depend on the type, dose, route, your age, and health. In 2026, regulators updated HRT labeling to better reflect the current evidence on benefits and risks.

Who it's for

It's individualized. A clinician weighs your symptoms, health history, and preferences to find the right type and dose - or non-hormonal alternatives if HRT isn't suitable.

When to see a doctor

To discuss whether HRT is right for you and which type and dose fit.

Read our perimenopause and menopause guide.

Femora helps you track symptoms before and during HRT so you and your clinician can see what's working.