Hormone therapy is replacement estrogen, or estrogen and progesterone that mimics the levels of hormones that are produced in a menstruating woman. Women who have a uterus require estrogen and progesterone to prevent uterine cancer. If women have had a hysterectomy, they require only estrogen.

The primary reason to take hormone therapy in menopause is to treat symptoms of menopause related to estrogen deficiency. These symptoms include hot flashes, night sweats, vaginal dryness, new sleep difficulties, new or exacerbated mood changes, changes in sexual desire, and new non-deforming joint pain.

Usually, new painful intercourse after menopause is related to vaginal thinning and lack of lubrication due to reduced estrogen levels. This can often be treated with lubricants, moisturizers, or local estrogen therapies.

This is a controversial topic.

The largest prospective randomized trial done in the U.S. showed that women who took one type of estrogen hormone actually had fewer cases of breast cancer. However, women who took estrogen and progestin (a synthetic type of progesterone) had 1-2 additional breast cancer cases in 1,000 women after five years.

Other studies have had mixed findings regarding hormone therapy in menopause and cancer risk.

The decision to take hormone therapy is individual evaluating symptoms, risks, benefits and patient wishes.

Hormone therapy is the most effective treatment for hot flashes and night sweats. Women may also derive benefit on their sleep and joint aches/pains. Hormone therapy is also helpful for mild mood symptoms around menopause and can work in conjunction with anti-depressants.

Hormone therapy has also been shown to have beneficial cardiovascular effects for women in their 50s without underlying heart disease, as well as beneficial effects on bone.