I frequently find myself discussing various health nuisances—indigestion, headaches, or just feeling off—with other women in my age group. It’s almost comical how quickly one of them declares it’s probably perimenopause and insists I should consider hormone therapy.
These exchanges always catch me off guard. Back in 2002, when I was studying medicine, a research study set off alarm bells for patients and doctors alike, suggesting that the risks associated with menopause hormone therapy (MHT)—like blood clots and certain cancers—outweighed its benefits. Fast forward to 2012, and deeper analyses with fresh data showed that these concerns mostly affected older women. Nowadays, many healthcare providers are more relaxed about prescribing hormones, and some even promote them as a one-size-fits-all solution.
While timely hormone treatment can significantly alleviate menopause symptoms and reduce the risk of fractures, it’s misleading to attribute all health issues to menopause and expect a quick fix from treatment.
Understanding what’s legitimate and where menopause treatments can genuinely help is essential.
Menopause is too often missed …
In a 2025 study from the Mayo Clinic, nearly a third of women reported experiencing noticeable menopause symptoms, yet only 13% sought treatment. According to Nanette Santoro from the University of Colorado, the actual percentage is likely lower than reported.
A major challenge is that menopause is only officially recognized a year after the last menstrual period, meaning many women miss the initial symptomatic window. Moreover, even when women do voice their menopause-related concerns, there’s a tendency for clinicians to dismiss their symptoms.
… and too often blamed
On the brighter side, awareness of menopause is increasing. Celebrity advocacy, social media, and a long-awaited cultural re-examination of women’s health have increased demand for care.
However, menopause isn’t the sole physiological change women experience as they age. By the time women reach perimenopause, at least half already struggle with a chronic medical condition. This newfound awareness leading women to seek medical attention may also result in them wanting hormones for symptoms with different origins—or no clear cause at all.
“It can be complex,” comments Lauren Streicher, a gynecologist and menopause researcher. “Is the dryness you’re experiencing due to being post-menopausal, a side effect of your medication, or just a normal part of aging?”
Why is there so much hype about MHT?
Claims circulate that MHT prevents weight gain, wards off dementia, protects against heart disease, and even extends life—yet these assertions lack solid backing.
Still, some influencers, including those with medical credentials, continue to amplify exaggerated claims on social platforms, significantly inflating the perceived effectiveness of estrogen. It’s worth noting that a substantial portion of the $10-15 billion menopause market is driven by products marketed by these content creators.
Most loud voices making these assertions cherry-pick data, as noted by Streicher. Last November, amidst much fanfare, the Department of Health and Human Services secretary and the then FDA commissioner inaccurately suggested MHT could prevent Alzheimer’s disease and extend life based on low-quality studies.
“Women are left questioning, ‘Who should I trust? My longtime clinician who seems out of the loop, or an influencer with millions of followers?’” Streicher adds.
What does MHT actually do?
Estrogen is the primary agent in MHT for alleviating symptoms. For individuals with a uterus, it’s mainly prescribed alongside progesterone, which lowers cancer risks associated with estrogen-induced growth of the uterine lining. (Notably, around one-fifth of women in this stage may have had a hysterectomy and therefore don’t require progesterone.)
Administering estrogen systemically helps alleviate hot flashes and sleep disruptions because estrogen receptors exist in areas of the nervous system that regulate these functions. Estrogen can be delivered via pills or skin applications like patches or gels. The oral route can produce byproducts that may lead to clotting, making skin application a safer choice for many.
These estrogen receptors are also present in the female reproductive system, meaning localized treatments can help with symptoms like itching and dryness. Options for localized therapy include vaginal creams and rings.
Pills are generally the best way to administer progesterone, though IUDs can be effective as well.
MHT could positively influence cardiovascular and bone health, but it’s not recommended as the initial preventive measure for these issues. Generally, it’s considered safe: for most women who start treatment within a decade post-menopause or prior to age 60, risks remain low—lower still for transdermal or localized estrogen.
Not all menopause treatments are hormone-based. Women who cannot take estrogen due to health histories, such as breast cancer, may find relief in experimental and recently explored non-hormonal options.
How do I know whether MHT is for me?
Distinguishing between tangible MHT benefits and the myths surrounding it can be quite difficult. For many women struggling with feelings of insignificance in medical settings, MHT may seem like a control mechanism.
Ultimately, making an informed choice is key. This may involve taking hormones during menopause, but it may not. The best route to determine whether MHT could be beneficial is to consult a clinician knowledgeable in current menopause therapies. Both The Menopause Society and author and expert Jen Gunter have resources for finding qualified healthcare providers.
