Is Hormone Replacement Therapy Safe? What the Latest Research Says

Hormone replacement therapy (HRT) was commonly prescribed in the 1980s and 1990s to manage symptoms associated with hormonal imbalances such as perimenopause, menopause, and low testosterone. However, that started to change in the early 2000s when preliminary results of a large study raised questions about its safety.

Because of that, some people today wonder whether they should consider HRT or avoid it altogether. But what does the science say, and is the fear surrounding this treatment warranted?

At OG Health in Greenwood Village, Colorado, concierge medicine physician Oswaldo "Ozzie" A. Grenardo, MD, MBA, MSHA, FAAFP, frequently uses HRT as part of his patient-centric treatment plans. Keep reading to learn why HRT has changed in popularity over the years, what the science says about its safety, and how to tell if it’s right for you.

Understanding the history of hormone replacement therapy

HRT may seem like a relatively new treatment, but it’s actually been around since the 1960s. Still, it didn’t become popular until the late ’80s and ’90s, when many doctors across the country began prescribing it to manage hormone imbalances, especially symptoms of menopause and related conditions.

Prescription levels began to decline around 2003 after initial results from the Women’s Health Initiative (WHI) suggested that certain types of HRT, specifically, a combination of estrogen and progestin, increased the risk of health issues, like blood clots, heart disease, and breast cancer.

These findings scared many people away, but subsequent research clarified that the initial concerns weren’t fully supported. A 20-year follow-up published in 2024 determined that HRT did not increase the risk of breast cancer or heart disease and that women who began treatment prior to age 60 experienced a decrease in all-cause mortality.

Safety depends on individual factors

That said, it’s important to understand that HRT isn’t a one-size-fits-all treatment. Certain people may be at higher risk for side effects, and different delivery methods present different benefits and risks. For example, transdermal hormone patches bypass the liver and reduce the risk of clotting, making them safer than oral forms. However, everyone responds to HRT differently, which is why it’s so important to work with a qualified provider like Dr. Grenardo.

Benefits beyond symptom relief

HRT is an effective way to relieve common hormone imbalance symptoms, such as:

Hot flashes
Night sweats
Mood swings
Sleep disruption

When used in the right doses, it can even make you feel like yourself again, allowing you to return to work and spend time with friends.

Beyond symptom relief, growing evidence suggests it may protect your health as a whole. For example, studies have found that it may support heart and brain health and reduce the risk of bone loss. However, timing is key. Some research suggests women who start treatment after 60 may be at risk for tau protein buildup, a key marker of Alzheimer’s disease.

Bottom line: Is HRT safe?

Many men and women benefit from using HRT as part of a personalized treatment approach for hormone imbalance. Research shows it can relieve uncomfortable symptoms and improve quality of life.

Recently, the Food and Drug Administration (FDA) even signaled openness to revising the warning labels currently placed on all HRT products, acknowledging that potential risks could have been overstated. However, because everyone reacts differently, it’s still important to approach the treatment thoughtfully and with care.

Schedule an HRT consultation to see if you can benefit

If you’re struggling to cope with the symptoms of hormonal imbalance, HRT is worth considering. After a review of your medical history, a discussion of your symptoms, and lab testing, we can determine if the treatment is right for you.