What hormone therapy can do
According to the North American Menopause Society's 2022 position statement, hormone therapy is the most effective treatment for hot flushes and night sweats. It also helps with vaginal and urinary symptoms and has been shown to prevent bone loss and fractures.
Who usually benefits more than they risk
For women under 60 or within ten years of menopause who have no contraindications, the same statement finds the balance favourable for bothersome hot flushes. Starting later carries a higher absolute risk of heart disease, stroke, blood clots and dementia, so the balance looks less favourable.
How large the risks are
- Breast cancer: combined products with oestrogen and progestogen slightly raise the risk. The NHS gives about 5 extra cases per 1,000 women after five years of use. Oestrogen alone raises it little or not at all.
- Blood clots and stroke: tablets slightly raise both; patches, gels and sprays don't, according to the NHS.
- Heart: hormone therapy has little or no effect on the risk of coronary heart disease, the NHS says.
Which product, in what form and for how long depends on age, medical history and your own risks. The European Society of Endocrinology's 2025 guideline covers this in detail, including for women for whom hormones aren't an option.
What changed in the US in 2025
In November 2025 the US Food and Drug Administration announced it would remove the boxed warnings on cardiovascular disease, breast cancer and dementia from product labels. The warning on womb cancer for oestrogen-only products stays. Critics consider the move too far-reaching. The risk figures above don't change because of it.
What this means for you
Whether hormone therapy suits you is a medical decision you make together with your doctor and review regularly. If you can't or don't want to take hormones, the evidence-based alternatives are in the article hot flushes without hormones.