The decision, untangled.
Twenty years after the WHI panic, the science has matured. Hormone therapy is neither miracle nor menace — it's a treatment with specific indications, specific risks, and a window in which the math is most favorable. This cluster helps you decide; it doesn't decide for you.
What hormone therapy actually does, the WHI study in honest context, the age-stratified evidence on risks and benefits, the difference between FDA-approved and compounded 'bioidentical' hormones, and a decision framework you can take into an appointment. Every absolute risk number on this page maps to a named peer-reviewed source — including the 2019 Lancet meta-analysis figures for combined estrogen-plus-progestogen therapy that are still missing from most popular menopause content.
Tell you whether to start HRT. Sell you a compounded prescription, a pellet, a saliva test, or a supplement that 'balances hormones.' Replace a conversation with a clinician who knows your full history. Every recommendation here is sourced; every author is named; every reviewer is a board-certified physician. Read our editorial standards →
The full guide
The decision, on your terms
What HT does, what it doesn't, the actual absolute risks by age, and what 'bioidentical' really means.
Pick the sentence that sounds most like yours.
Print it, take it to your doctor.
A two-week symptom log designed with three menopause-trained clinicians. Tracks the eleven symptoms most likely to be dismissed when reported one at a time — and the patterns that read clearly to a GP at a glance.
- One page. Two weeks. Eleven symptoms.
- Designed with menopause-trained clinicians.
- Printable and fillable PDF.
Send it to your inbox
What women ask us first.
It depends on the type and how long. The 2019 Lancet meta-analysis of 58 studies found combined estrogen-plus-daily-progestogen therapy taken for 5 years starting at age 50 raises 20-year breast cancer risk from 6.3% to 8.3% — about 2 extra cases per 1,000 women per year of use. Estrogen-only therapy (used after hysterectomy) carries a much smaller increase, and in the WHI trial was actually associated with reduced breast cancer incidence. The 'less than 1 in 1,000' figure you'll see online conflates these two.