Menopausal Hormone Replacement Therapy

Paige McClincy • July 12, 2026

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Menopause is a natural stage of life, but that doesn't mean you have to suffer through it.

As estrogen levels decline, many women experience symptoms that affect their daily lives. Hot flashes, poor sleep, brain fog, joint aches, mood changes, vaginal dryness, painful intercourse, and decreased libido are all common. Some women have only mild symptoms. Others find menopause significantly impacts how they feel each day.

The good news is that effective treatments are available.


Is Hormone Therapy Safe?


This is the question I hear most often.

When it comes to vaginal estrogen, the answer is absolutely yes, for every patient.

For systemic therapy (patch, pill, topical cream/gel), the answer requires more nuance. For the majority of women, the answer will be yes, but it’s important to evaluate and counsel each woman individually. 

Much of the concern about hormone therapy came from the Women's Health Initiative study published in 2002. Early reports raised fears about breast cancer and heart disease. Looking back, 20 years later, this study wasn’t interpreted in the best way, from a public health perspective. Today, major medical organizations agree that hormone therapy is safe and effective for many women when prescribed appropriately. The key is choosing the right treatment for the right patient.


What Are the Benefits?


Hormone therapy is the most effective treatment for hot flashes and night sweats. It can also:

·      Improve sleep

·      Reduce vaginal dryness and discomfort with intercourse

·      Improve mood and quality of life

·      Help preserve bone density and reduce the risk of osteoporosis

·      Many women also notice better energy and improved mental clarity, although these benefits vary from person to person.


What Treatments Are Available?


Hormone therapy is not one-size-fits-all.

Treatment options may include:

·      Estrogen tablets, patches, gels, or sprays

·      Progesterone for women who still have a uterus

·      Low-dose vaginal estrogen for dryness, discomfort, and recurrent urinary symptoms

For some women, testosterone therapy may also be appropriate. Although it is not routinely recommended for every menopausal woman, carefully prescribed testosterone can improve sexual desire in women with persistent low libido after other causes have been addressed. It should be prescribed thoughtfully and monitored regularly.


Is Hormone Therapy Right for Everyone?


No.

Hormone therapy may not be recommended for some women, including those with certain types of breast cancer, unexplained vaginal bleeding, active liver disease, or a history of blood clots or certain strokes.

A careful review of your medical history helps determine whether hormone therapy is a good option for you.


Our Approach


There is no single "best" treatment for menopause. Every woman is different.

At Rivanna Concierge Physicians, we take the time to understand your symptoms, discuss the latest evidence, and develop a treatment plan that fits your goals and your health history. For some women, that includes hormone therapy. For others, it may not.


Our goal is simple: to help you feel like yourself again and enjoy the years ahead with confidence and good health.



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