Hormone replacement therapy (HRT) uses estrogen, often with a progestogen, to treat menopause symptoms. It is FDA-approved for hot flashes, night sweats, vaginal dryness and painful sex, and can help reduce the chance of osteoporosis. For many healthy women under 60, or within 10 years of menopause, benefits may outweigh risks. Not everyone is a candidate.
During and after menopause, the ovaries make much less estrogen. HRT replaces some of it to ease symptoms. There are two main types:
Low-dose vaginal estrogen is a separate, local treatment for dryness and painful sex. Very little of it reaches the bloodstream. See vaginal dryness (GSM).
FDA-approved HRT includes:
The form matters. For example, estrogen through the skin (patch or gel) does not carry the extra blood clot risk linked to estrogen pills. Your clinician will help you weigh this based on your health.
The Menopause Society says that for women under 60, or within 10 years of menopause, with no reasons to avoid it, the benefits of HRT generally outweigh the risks for bothersome hot flashes and for preventing bone loss. Starting HRT later, after 60 or more than 10 years after menopause, carries more risk of heart disease, stroke, blood clots and dementia.
HRT is usually not used if you have:
This list is not complete. Your clinician will review your full history.
Possible side effects include breast tenderness, bloating, headaches and spotting or bleeding, especially in the first months.
More serious risks depend on your age, the type of HRT, the dose, how it is taken and how long you use it. They include:
In 2026 FDA updated some HRT labels, but that does not mean HRT has no risks. We review benefits and risks with you at the start, and again at follow-up visits.
"Bioidentical" means a hormone has the same structure as the one your body makes. Some FDA-approved products are bioidentical, such as estradiol and micronized progesterone. Compounded hormone mixes are not FDA-approved, and the evidence does not show they are safer or work better. Read more in our guide to bioidentical hormones.
Every plan starts with a visit with Leticia Vargas, MD, OB/GYN. She asks about your symptoms, periods, health history and family history. You may need an exam, a blood pressure check, a mammogram that is up to date, or lab tests. If HRT fits, you agree on a type and dose together. Follow-up visits check how you feel, side effects and any bleeding. Many follow-ups can be done by telehealth if you are located in Texas.
How long does it take for HRT to work? It varies. Some women notice fewer hot flashes within weeks. It can take a few months to find the right dose and form.
Is HRT safe now that FDA changed the warning? FDA removed some statements from the boxed warning on certain products in 2026. The risks are still in the labels, and the endometrial cancer boxed warning remains for estrogen-alone pills and patches. Safety depends on your age, health and the type of HRT.
How long can I stay on HRT? There is no single cutoff. Some women continue past 60 or 65 after a review of benefits and risks with their clinician.
Can I start HRT by telehealth? Some visits can be done by telehealth if you are located in Texas. An in-clinic visit may be needed for an exam or tests before you start.
Talk with Leticia Vargas, MD, OB/GYN, about whether HRT fits you. Call (210) 903-1030 or book a visit. In-clinic in San Antonio • Telehealth for women located in Texas Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223
About the clinician: Leticia Vargas, MD, OB/GYN, founder of Yaso Wellness Health Clinic. About Dr. Vargas
Education only, not medical advice or a diagnosis. In an emergency, call 911.
