Long-term Hormone Replacement Therapy (HRT) for menopause carries risks including increased chances of breast cancer, blood clots (VTE), stroke, and, for those with a uterus, uterine/endometrial cancer, with risks generally rising with age and duration of use, though benefits like reduced fractures exist. Other concerns include potential heart disease risks for older starters, gallbladder issues, and liver disease.
Possible health risks include: Increased risk of uterine cancer (only if you still have your uterus and aren't taking progestin along with estrogen). Increased risk of heart disease if you begin using HRT 10 years after menopause starts. Increased risk of blood clots and stroke.
Research on HRT and dementia risk
With some suggesting a benefit on memory and thinking abilities, or dementia risk, and others finding the opposite. In 2021 a study of nearly 400,000 women, found both new and old HRT drugs reduced the risk of diseases that cause dementia.
Nausea and vomiting can occur with some hormone therapy drugs. These side effects usually get better as the body gets used to the drug. Taking hormone therapy drugs with food or at bedtime may help relieve these side effects. Nausea and vomiting can also occur a few hours after radiation therapy to the abdomen.
There is no set length of time you should take HRT for; it is an individual decision between yourself and your doctor or nurse.
On November 10, 2025, the Department of Health and Human Services announced that the Food and Drug Administration will begin to remove the "black box" warning language related to increased risks of cardiovascular disease, breast cancer, and probable dementia from hormone replacement therapy (HRT) products for menopause ...
Risks of long-term use
For example, if a person takes a combination of estrogen and progestin for longer than 5 years , the risk of breast cancer may increase even after they stop HRT. Other potential risks of long-term HRT use include: increased risk of breast cancer. increased risk of blood clots.
For some, menopause hormone therapy may increase the risk of: Heart disease. Stroke. Blood clots.
For people with certain existing conditions and risk factors, it will definitely be better to go through menopause naturally. Others may choose to. And, for some, HRT is the only suitable option. Importantly, picking natural menopause management doesn't have to mean suffering unbearable menopause symptoms.
Is there any food or drink I need to avoid? You can eat and drink normally while taking continuous combined HRT. Try to have a healthy diet, as this can help with menopause symptoms and keep you well. Cutting down on alcohol and caffeine may help reduce hot flushes.
Estrogen deficiency following menopause results in atrophic skin changes and acceleration of skin aging. Estrogens significantly modulate skin physiology, targeting keratinocytes, fibroblasts, melanocytes, hair follicles and sebaceous glands, and improve angiogenesis, wound healing and immune responses.
The cause of roughly 70% of all dementia cases is Alzheimer's disease, a progressive brain disorder characterized by the buildup of amyloid plaques and tau tangles, leading to memory loss and impaired thinking that interferes with daily life, making it the most common form of dementia.
Luteinizing Hormone in Alzheimer Disease
Notably, such an increase in neuronal LH appears to be a very early change in disease progression serving to predict neuronal populations at risk of degeneration and death.
The worst symptoms of menopause that women say they experienced were:
Progestogen containing patches may slow down the intestinal movements, leading to difficulties in bowel movements. It is important for users of combined HRT patches to be aware of this potential side effect and to discuss any concerns with their healthcare provider to manage the symptoms effectively.
By the age of 60, arteries are generally stiffer and women at this age are more at risk of cardiovascular disease, hence commencing hormone therapy may increase their risk of cardiovascular disease or events. High blood pressure would increase this risk as well.
So if you do decide not to take HRT but want to manage the symptoms of the menopause, try more exercise, cut down on alcohol and coffee and maybe consider increasing the amount of tofu or other soya products, or flaxseed in your diet.
Here are the top five vitamins essential for female wellness during menopause.
Study Looked at More Than 100,000 Women
But overall, the discrepancy between chronological age and biological age was 0.17 years smaller for the women who used HRT than it was for the women who didn't, according to findings published in JAMA Network Open.
After more than two decades of fear and misinformation surrounding hormone replacement therapy (HRT), the U.S. Food and Drug Administration (FDA) is initiating the removal of broad “black box” warnings from HRT products for menopause. Health and Human Services Secretary Robert F. Kennedy Jr.
Hormone replacement therapy (HRT) HRT is a safe and effective treatment for most going through menopause and perimenopause. Your GP will discuss any risks with you. HRT involves using oestrogen to replace your body's own levels around the time of the menopause.
Benefits and risks if you're older
As you get older, and particularly after the age of 60, the risks of HRT may start to outweigh the benefits. This is because you'll usually find that menopause symptoms improve as you get older, so you're less likely to need HRT to help with symptoms.
Wearing loose clothing and increasing ventilation in your sleeping area can minimize the disruption of night sweats. Managing stress can relieve mood swings, and practices like tai chi and yoga can help you maintain calm and relaxation. Lubricants and moisturizers can help with vaginal dryness.
Certain types of hormone therapy sometimes cause late side effects after treatment ends. These side effects can happen long after cancer treatment, such as bone loss (osteoporosis) or increased risk of heart disease. People often become discouraged about how long their treatment lasts or the side effects they have.
A meta-analysis of 28 randomized controlled trials (including three trials that included men) suggested a 29% increase in stroke due to hormone use (95% CI 1.1 to 1.5)26. Risk was confined to ischemic stroke.