Is HRT the answer?

Although menopause is a biological process that every woman experiences in some way, shape, or form, the symptoms related to it often feel anything but natural. The debate around hormone replacement therapy (HRT) has been ongoing for decades – should you treat the cause (hormone fluctuations and decline) or the symptoms that result from it?

Whether it’s due to perimenopause, postmenopause, medical, surgical or chemically induced menopause, changes are inevitable –  but how to manage them is a highly personal choice, with pros and cons on all sides.

This article explores the role of HRT in managing menopausal symptoms, weighing its potential benefits and risks while also examining alternative approaches and lifestyle adjustments that some women choose to explore to relive the multitude of symptoms. The goal is to present balanced, evidence-aware information to help you make the best decision for your individual circumstances.

Hormone replacement therapy (HRT) involves supplementing the body’s natural hormone levels—typically oestrogen and sometimes progesterone or testosterone. HRT can be administered through pills, patches, gels, or implants and aims to alleviate symptoms caused by hormonal fluctuations (NHS, 2025; Mayo Clinic, 2025).

1. Symptom relief: HRT is widely used and considered effective for managing many symptoms, such as hot flushes, night sweats and vaginal dryness, although responses vary between individuals
2. Bone health: Oestrogen plays a role in maintaining bone density, and HRT may help reduce the risk of osteoporosis for some women, particularly when started around the time of perimenopause (NICE, 2024; Cochrane Library, 2024).
3. Mood stability: Some women report improvements in mood or anxiety (North American Menopause Society, 2024).
4. Cognitive health: There is some evidence emerging that HRT may lower the risk of Alzheimer’s disease, this is ongoing research into the relationship between hormones and long-term cognitive health (Harvard Medical School, 2024).

1. Blood Clots: Oral HRT may increase the risk of deep vein thrombosis and pulmonary embolism (JAMA, 2025).
2. Stroke and heart disease: The risk may vary depending on age, health history, and the type of HRT (British Menopause Society, 2024).
3. Side effects: These may include bloating, breast tenderness and mood changes, although not everyone experiences side effects.

1. Lifestyle adjustments: Regular exercise, diet, and stress management can significantly reduce symptoms and are commonly recommended as part of overall wellbeing.
2. Holistic therapies: Acupuncture, yoga, and meditation have shown promise for some women.
3. Supplements: Black cohosh, red clover, and soy isoflavones are popular natural supplements
4. Cognitive Behavioural Therapy (CBT): Proven effective for managing mood swings and sleep disturbances (NHS, 2025).

Women may choose to directly address hormonal chaos through HRT or focus on managing symptoms through lifestyle and holistic approaches such as supplements. It’s important to understand that treating the root cause can provide broader symptom relief, while treating some symptoms individually may require a combination of methods such as lifestyle changes and supplements.

Choosing whether to use HRT or an alternative approach is a deeply personal decision that should be guided by thorough research and professional medical advice. It’s essential to consider your personal health history, risk factors, and individual symptom severity.

Annoyingly there is no one-size-fits-all answer. Whether opting for HRT, lifestyle changes, or a combination of both, you should feel empowered to choose a path that best suits your health needs and personal preferences. Staying informed, doing research, listening to your own body and talking to healthcare providers are key to making the right choice. And, don’t let anyone judge you on how you chose to manage this huge phase in your life. Alot of women report feeling ‘fobbed off’ by their GP so if If you do find yourself wanting to explore the HRT route go armed with the information you need. You can read more about advocating for yourself in our guide to getting heard by your GP.

This article is for general information only and is not intended as medical advice. Everyone’s experience of perimenopause and menopause is different. Always speak to a qualified healthcare professional before making changes to medication, supplements or treatment.

Last reviewed: Feb 2026
Next review due: August 2026