Understanding HRT and Other Treatment Options

What you will be able to do

• explain the difference between combined and estrogen-only HRT, and why progestogen is added for people with a uterus.
• describe the main forms of HRT and why the risks differ for pills compared with patches, gels and sprays.
• summarize the benefits and risks of HRT in the way current US health information describes them.
• tell the difference between absolute and relative risk, and ask for your own risks as numbers.
• describe local options for vaginal and urinary symptoms, including what you can and cannot buy over the counter.
• outline non-hormonal options, including CBT, and what US agencies say about herbal and compounded products.
• prepare for and take part in a shared decision with your doctor or pharmacist, and know what happens at reviews.

1. 1Why treatment options exist, and how menopause care works in the US

   A short reminder of what changes around menopause, then how decisions about treatment are made in the US, so you know who does what before you look at the options.

   • Menopause in brief: what treatment is trying to help
   • How decisions are made: your doctor, US guidance and shared decision-making

   Questions for my doctor or pharmacist

2. 2HRT explained: the hormones, the forms and the patterns

   What is in HRT, why some people need two hormones, the different ways it can be taken, and the terms you will hear in your appointment.

   • Estrogen and progestogen: why there are two types of HRT
   • Ways to take HRT: pills, patches, gels, sprays and more
   • Cyclical or continuous: the patterns of combined HRT

   Menopause options comparison sheet (education only)

3. 3Benefits and risks, as US health information describes them

   What HRT can help with, how to make sense of risk numbers, what changed with the FDA's 2025 labeling update, and the specific risks and side effects to know about.

   • What HRT can help with
   • Making sense of risk: absolute and relative numbers
   • The risks one by one, side effects and who may not be suited

   Questions for my doctor or pharmacist

4. 4Vaginal and urinary symptoms: local options

   Why vaginal and bladder symptoms happen, the local treatments available in the US, and what you can and cannot buy over the counter.

   • Genitourinary symptoms: common, treatable and often not mentioned
   • Vaginal estrogen, moisturizers, lubricants and other options

   Menopause options comparison sheet (education only)

5. 5Options besides HRT

   Talking therapy, non-hormonal medicines, herbal and "natural" products, and everyday habits, described the way US health agencies describe them.

   • CBT: a talking therapy US experts list for menopause symptoms
   • Non-hormonal prescription medicines
   • Herbal products, 'bioidentical' hormones and everyday habits

   Menopause options comparison sheet (education only)Myths vs evidence cards

6. 6Your doctor or pharmacist conversation

   How to prepare, what to ask in the room, and what happens afterward, including reviews, costs and how decisions about stopping are made.

   • Before the appointment: getting ready
   • In the room: questions that help you decide together
   • After the appointment: reviews, prescriptions, costs and stopping

   Questions for my doctor or pharmacist

7. 7Myths, evidence and trustworthy information

   Common myths about menopause treatment, how to judge what you read and see online, and your next steps.

   • Common myths, and what the evidence says
   • Judging what you read, and your next steps

   Myths vs evidence cardsMenopause options comparison sheet (education only)

• ListMenopause options comparison sheet (education only)Side-by-side summaries of the main treatment options US health agencies and menopause experts describe, with space to add your own notes and questions before you see your doctor or pharmacist.
• TemplateQuestions for my doctor or pharmacistA one-page prep sheet so you can explain how symptoms affect you, share the history a prescriber needs, and ask the questions that matter to you.
• CardsMyths vs evidence cardsPocket cards that set common menopause treatment myths against what current US health information actually says, to help you sort fact from fear before a conversation with your doctor.