- Hormone replacement therapy (HRT) can help improve symptoms associated with menopause, but it is also sometimes associated with certain health risks.
- However, recent research suggests that the available evidence does not support the idea that HRT can cause harm during and after menopause.
- In fact, some recent studies have linked it to better weight management and improved bone health.
These are due to changes or decreases in hormone levels, especially estrogen. The main way to manage menopause symptoms is through hormone replacement therapy (HRT), also known as menopausal hormone therapy.
Historically, doctors have been concerned that hormone therapy can sometimes result in serious side effects, but the narrative is now changing, as evidence increasingly suggests that not only is HRT safe, but it may be associated with more benefits than previously thought.
Here’s some of the latest research and what it found.
The review analyzed data from 10 studies, nine of which were observational, and one of which was a randomized control trial, with 1,016,055 participants between them.
Its findings appear to support a decision by the Food and Drug Administration (FDA) in November 2025 to remove black box warnings for HRT products to clarify the safety of such treatments.
Commenting on the removal of the black box warning, Prudence Hall, MD, an OB/GYN in private practice in Santa Monica, CA, said. Today’s Medical News The hormone replacement therapies that are currently available have greatly improved in quality, compared to the products that were available historically.
“Decades ago, starting around 1945, a product called Premarin, derived from the urine of pregnant horses, was commonly prescribed with synthetic progesterone,” Hall explained.
“Today, we have much better, more natural options, the form of HRT that I use [in clinical practice] is bioidentical, meaning that these hormones are molecularly identical to those produced naturally in a woman’s body,” she noted.
Specifically, postmenopausal women taking HRT plus teresapide lost 35% more weight than those taking teresapide without HRT.
“The significant weight loss we observed suggests that menopausal hormone therapy may be an important modifier of response to terzapatide, pointing toward a more personalized approach, where menopausal status and use of menopausal hormone therapy are considered when counseling midlife women and designing treatment plans.”
First author Regina Castaneda, MD, a postdoctoral researcher at the Mayo Clinic, cautioned that the study was observational and could not, thus, prove a causal relationship.
However, Castaneda said the study “highlights the need for prospective trials to determine whether menopausal hormone therapy alters the response to obesity pharmacology.”
Another concern during and after menopause is increased osteoporosis due to reduced estrogen production.
The study included 137,484 people under the age of 60 who had gone through menopause.
this found that those who did not start HRT within a year of the onset of menopausal symptoms had an 18% greater risk of osteoporosis at 5-year follow-up than those who started hormone therapy.
“As our population ages, age-related conditions such as bone loss become common, and the risk of bone loss and fracture increases rapidly. From an orthopedic perspective, this often leads to hospitalization, surgery and morbidity.”
“Anything we can do to reduce the risk of osteoporosis and fractures for postmenopausal women is a positive step,” James Barsey, MD, FAAOS, clinical associate professor of orthopedic surgery at Stony Brook University, NY, and one of the study’s authors, said in a press release.
“The data from this study are particularly meaningful because of the large number and homogeneity of the participants, and we hope it encourages more doctors to discuss HRT as an option with eligible patients,” Barsi concluded.
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