This is a long one so get a cup of tea, put your feet up and settle in!

If you’re anywhere near perimenopause, you’ve probably heard of HRT.

And most people have heard it can be used to treat a lot of the symptoms of the menopause but aren’t sure if it comes with too many risks.

(spoiler, it doesn’t but we’ll cover EVERYTHING so stand by)

Let’s clear it up — without fear, fluff, or outdated information.

At this point I also need to make crystal clear that I’m NOT here to recommend it. It isn’t in my scope or skill set. BUT what I can do is give you ALL the most up to date information so you can make an informed choice that suits you. Whatever path you take it YOUR decision. No one else’s. Come at it from a position of knowledge and power.

What Actually Is HRT?

HRT stands for Hormone Replacement Therapy.

It’s a treatment that replaces the hormones your body stops making during menopause, mainly oestrogen and progesterone. Sometimes testosterone too.

It can come in many forms:

• Skin patches

• Gels

• Tablets

• Sprays

• Vaginal creams or pessaries

• Implants

The goal? To bring your hormone levels back up to a range that eases symptoms and supports long-term health.

Why Do People Take It?

HRT is often used to reduce or relieve symptoms of perimenopause and menopause, including:

• Hot flushes and night sweats

• Sleep problems

• Mood swings, anxiety, and low mood

• Vaginal dryness or painful sex

• Brain fog

• Low libido

• Joint pain

• Loss of confidence or motivation

And beyond symptom relief, HRT also has long-term protective benefits, such as:

• Reducing the risk of osteoporosis and bone fractures

• Supporting heart health when started before age 60

• Helping maintain muscle mass and joint mobility

• Possibly reducing the risk of type 2 diabetes and dementia (more research is still ongoing)

So Why the Controversy?

In the early 2000s, a large study called the Women’s Health Initiative linked HRT with a small increased risk of breast cancer and blood clots. The results were leaked to the press before they were properly analysed and like all bad news stories, it was sensationalised and made headlines.

The result? Decades of mistrust, misinformation and panic from both public and GP’s who stopped prescribing it.

But here’s the truth: that study had serious flaws

It studied postmenopausal women with average age of 63, many had pre existing health issues AND they used an older, synthetic form of HRT (not body identical HRT which is used today). Plus the increased risk was very small and only related to one type of combined HRT.

Much of it has since been revised and reinterpreted. But the damage is still there. The fear is still real and more work needs to be done to dispel it.

We now know that:

• Risks vary depending on age, type of HRT, and individual health history

• BUT it’s now commonly accepted that for most women under 60 (or within 10 years of menopause), the health benefits outweigh the risks

• And actually beyond 60, most recent evidence shows that there are significant reasons why taking HRT is beneficial - especially in terms of protecting the body from inflammation and disease.

• Body-identical HRT (also called body-identical or regulated bioidentical HRT) is much safer than older synthetic types

Still, many GPs haven’t caught up with the newer guidance — so it’s worth finding a menopause-aware doctor who’s up to date.

Is HRT Right for Everyone?

Not necessarily.

Some women:

• Can’t take HRT for medical reasons (e.g. certain types of breast cancer or clotting disorders)

• Choose not to take it and prefer lifestyle changes or natural alternatives

• Want to try it but start with a low dose or localised option (like vaginal oestrogen)

It’s a personal decision — and you get to choose what’s right for your body.

The Bottom Line

HRT isn’t a miracle cure, and it isn’t for everyone.

But for many women, it’s life-changing.

It can bring relief. Restore sleep. Reignite confidence. And protect your long-term health.

You deserve balanced information and options — not scare tactics or shame. This is your journey, your body, and your choice.

I have another post with FAQ around HRT. So if you still have questions (and let’s face it, most of us will), make sure you check it out. There’s a lot to unpick.