Getting the Whole Picture on Menopause Treatment

Menopausal hormone therapy (MHT) is a common treatment, but do its benefits outweigh its risks? A recent review supplies important insights.


Menopause is a natural process in the life of a person with ovaries, during which menstruation ceases and various physical and emotional changes occur. This transitional period, which can last up to 10 years, is characterized by a decline in the production of estrogen, resulting in symptoms that can have a negative impact on the person’s well-being.

Menopausal hormonal therapy (MHT) is a common treatment for menopausal symptoms, but in the past two decades, concerns have arisen regarding the potential health risks associated with MHT use. Therefore a recent review led by Iliana Lega, a Staff Endocrinologist from Women’s College Hospital and Assistant Professor in the Department of Medicine at the University of Toronto, examined the benefits and risks of using MHT to treat menopausal symptoms.

The review was published in the Canadian Medical Association Journal, and included studies up until April 2022 that assessed MHT for menopausal symptom treatment.

The review demonstrated that the majority of research is in favour of women using MHT for treating symptoms of menopause. Specifically, MHT was shown to reduce moderate-to-severe night sweats and hot flashes, common menopausal symptoms, by up to 90%.

In addition, the studies showed that MHT can improve sleep quality and mood disturbances. MHT may also lower the risk of coronary heart disease, the incidence of osteoporosis-related fractures, and overall mortality when initiated before the age of 60 or within 10 years of menopause onset. Finally, MHT may improve insulin sensitivity, and in turn reduce the risk of diabetes.

While MHT offers numerous advantages, the researchers also found studies that highlighted MHT’s potential risks. For example, combined MHT (estrogen and progestin) has been associated with a slight increase in the risk of breast cancer and ischemic stroke. However, this risk was relatively low among MHT users aged 50-59 years and/or MHT users who initiated treatment within the first 10 years of menopause.

In summary, based on the research, MHT seems to be an effective primary treatment for menopausal symptoms unless contraindications are present. Overall, Lega and colleagues highlighted the potential benefits and risks of MHT, which people with ovaries and their doctors can use to make informed decisions about managing menopausal symptoms and improving their overall well-being.

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Alexandria (Alex) Samson is a PhD student in the Department of Psychology at the University of Toronto. She completed her BSc in Neuroscience from Dalhousie University. Alex is a strong believer in open science and is passionate about making scientific research accessible to all audiences.