In recent years, the terminology around hormone therapy for menopause has evolved. What was traditionally known as Hormone Replacement Therapy (HRT) is now more accurately referred to as Menopause Hormone Therapy (MHT).
While the terms are often used interchangeably, they carry different implications. HRT suggests the replacement of hormones to correct a deficiency—implying that hormone levels are restored to pre-menopausal levels, as if treating a medical condition. However, menopause after age 45 is a natural physiological transition, not a disease. In this context, MHT is a more appropriate term, as it reflects the goal of alleviating symptoms rather than replacing hormones to a specific baseline.
This distinction is important when comparing MHT to treatment for Premature Ovarian Insufficiency (POI)—menopause occurring before age 40—where hormone therapy aims to mimic the levels typical of reproductive years.
I regularly prescribe MHT to help manage symptoms of menopause and support aspects of health, particularly bone health. For most women, MHT is safe and can significantly improve quality of life.
However, public discourse around MHT has shifted dramatically. The rise of menopause influencers, often promoting products or services, has led to MHT being portrayed as a cure-all. In some cases, it’s recommended at high, unstudied doses, with potential risks—such as breast cancer recurrence—being downplayed.
I guide my patients with a balanced approach:
- The primary role of MHT is symptom relief and bone health support.
- Claims about MHT preventing dementia or cardiovascular disease are not supported by robust evidence. The data is highly variable and influenced by many confounding factors.
- If MHT had a significant impact on these conditions, we would see clear trends in population-level data.
Ultimately, the best strategies for long-term health remain the fundamentals: regular exercise, a balanced diet, avoiding smoking, and managing blood pressure and glucose levels.
MHT is a valuable tool for managing menopause symptoms—but it’s not a panacea, nor is it necessary for everyone.