In most cases the benefits of HRT far outweigh the risks. The risks depend on the type of HRT you use, how long you take it and your medical history.
The benefits of HRT include:
Reduced menopausal symptoms (hot flushes, night sweats, improve sleep: higher energy levels and improved mood, relieves vaginal dryness, improves urinary symptoms, improve libido and reduce pain during sex, improve skin condition, improve joint pain and help with dry eyes) therefore improving quality of life.
Reduced risk of fractures: HRT reduces loss of calcium and helps maintain bone mineral density (strength). HRT promotes new bone growth and prevents chance of osteoporotic fractures.
Improved muscle mass and strength
Reduced risk of cardiovascular disease and osteoporosis: Relaxes smooth muscles and therefore lowers blood pressure. HRT prevents build up of fatty deposits on the blood vessels, encourages cholesterol to increase HDL and lower LDL and therefore reducing risk of heart attacks and strokes.
The risks of HRT include:
Venous thromboembolism (VTE): Blood clots. These risks are increased when taking oral medication (although still small). Evidence suggests patches have no greater risk than patients not using medication.
Heart disease and stroke: HRT with oestrogen alone is associated with no or reduced risk of heart disease. Combined HRT (oestrogen and progesterone) carry little or no increase in the risk of heart disease. Risk of stoke in women under 60 is very low. Oral oestrogen (not patches) are associated with a small increase in the risk of stoke). HRT does not increase cardiovascular disease risk whens tarted in women younger than 60 years.
Breast Cancer: Oestrogen only HRT is associated with little or no increased risk. Combined HRT is associated with increased risk of breast cancer and is dependent on the duration of treatment (reduces after stopping HRT). The risk is slightly lower with cyclical compared to continuous HRT.
Here’s some information extracted from MHRA:
In the UK about 1 in 16 women who never use HRT are diagnosed with breast cancer between the ages of 50
and 69 years. This is equal to 63 cases of breast cancer per 1000 women.
Over the same period (ages 50–69 years), with 5 years of HRT use, the study estimated:
- about 5 extra cases of breast cancer per 1000 women using estrogen-only HRT
- about 14 extra cases of breast cancer per 1000 women using estrogen combined with progestogen for part of each month (sequential HRT)
- about 20 extra cases of breast cancer per 1000 women using estrogen combined with daily progestogen HRT (continuous HRT)
These risks are for 5 years of HRT use. The numbers of extra cases of breast cancer above would approximately double if HRT was used for 10 years instead of 5.
Endometrial Cancer: women who have not had hysterectomy and are postmenopausal are at increased risk of endometrial cancer if they take oestrogen only HRT
Ovarian Cancer: Increased risk is every small (0.4 increased risk per 1000 women compared to someone not taking HRT)