Menopausal Hormone Therapy Eligibility

Menopausal hormone therapy — also called MHT or HRT — replaces some of the estrogen (and, for people who still have a uterus, progestogen) that the ovaries stop making at menopause. It's the most effective treatment for bothersome hot flashes and night sweats and for genitourinary symptoms like vaginal dryness and painful sex, and it also helps protect bone. It comes in systemic forms that treat the whole body — pills, patches, gels, sprays — and in a low-dose vaginal form that treats local symptoms only. It isn't right for everyone, and whether it's a good fit depends on your symptoms, your age and how long you've been past menopause, and your health history, which is exactly what a clinician weighs with you.

It's the finding that the benefit-to-risk balance of systemic hormone therapy is most favorable when it's started close to menopause. The Menopause Society's 2022 position statement concludes that for healthy people under 60, or within 10 years of their last period, who have bothersome symptoms and no contraindications, the benefits generally outweigh the risks. Starting systemic hormones much later — after 60 or more than 10 years past menopause — shifts that balance less favorably, so it's generally not started fresh that late. This tool asks about your timing for exactly this reason. Low-dose vaginal estrogen for local symptoms is low-risk at any age.

Because estrogen on its own stimulates the lining of the uterus (the endometrium), which over time can raise the risk of endometrial cancer. To prevent that, anyone who still has a uterus and takes systemic estrogen also takes a progestogen, which keeps the lining in check — this combination is estrogen plus progestogen. If you've had a hysterectomy and have no uterus, there's no lining to protect, so estrogen alone is used. That single fact changes which regimen a clinician would consider, which is why the tool asks.

Not necessarily, but it does mean systemic hormone therapy isn't a straightforward option and the conversation belongs with a specialist rather than a screen like this. A history of breast or other estrogen-sensitive cancer, a past blood clot or stroke, coronary heart disease, active liver disease, or unexplained vaginal bleeding each change the risk picture. Importantly, low-dose vaginal estrogen is a different story: because so little is absorbed, it's often still an option for local symptoms even for many people with these histories — for breast-cancer survivors, in consultation with their oncologist. And effective non-hormonal treatments exist for hot flashes. So a flag routes you to a specialist, not necessarily away from all relief.

No. Low-dose vaginal estrogen treats genitourinary symptoms — dryness, irritation, painful sex, some urinary symptoms — locally, and only a tiny amount reaches the bloodstream, so it doesn't carry the same considerations as systemic estrogen taken by pill, patch, gel, or spray. Major guidelines regard it as low-risk, and ACOG notes it can be considered even for many people with a history of estrogen-dependent breast cancer after a discussion with their cancer team. It won't treat hot flashes (that needs a systemic or non-hormonal approach), but for local symptoms it's a well-tolerated, low-risk option worth raising with a clinician.

Yes. This tool runs entirely in your browser. Your answers are read on your own device and are never sent to a server, saved, or shared — close the tab and they're gone. It's general educational information based on published Menopause Society and ACOG guidance; it can't prescribe for you, isn't a diagnosis, and doesn't replace a conversation with a clinician who can weigh your full health picture.