What are the benefits of HRT?

HRT's main benefit is highly effective relief of menopause symptoms, including hot flushes, night sweats, sleep problems, mood changes and vaginal dryness, plus protection for your bones.

For most women with troublesome symptoms, HRT, which replaces the oestrogen (and progesterone if you have a womb) that your body has lost, is the most effective treatment available. Its benefits group into three:

• Symptom relief — the strongest evidence is for hot flushes, night sweats and the sleep and mood disruption that come with them
• Bone protection — it reduces the risk of osteoporosis and fractures by preserving bone density
• Local genitourinary relief — vaginal oestrogen is very effective for dryness and urinary symptoms, with minimal whole-body effect

Started around the time of menopause, generally under 60 or within 10 years of your last period, HRT is, on balance, a reasonable and often beneficial choice for many women. Modern guidance is far more positive than the fear-driven era that followed older studies, much of which has since been reinterpreted. The timing point matters: the benefit-to-risk balance is most favourable when HRT is started near menopause rather than many years later, which is part of when to start HRT.

Like any treatment, HRT carries risks and is not right for everyone, which is why it is an individual decision made with your doctor, and the other half of the picture is set out in HRT side effects.

There is also a heart angle worth understanding. Starting HRT near menopause, within that under-60 or 10-year window, appears neutral to favourable for cardiovascular health in most women, whereas starting many years later shifts the balance. This "timing hypothesis" is a large part of why modern guidance is so much warmer than the blanket caution of twenty years ago.

What to do: if menopause symptoms are affecting your quality of life, or you are concerned about bone health, it is worth a proper conversation with your GP about whether HRT suits you, weighing your symptoms, age, health history and preferences. The type, dose and delivery, whether patch, gel or tablet, can all be tailored to you.