What is Menopausal Hormone Therapy (MHT) and is it safe?

What is MHT and is it safe


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At menopause, a decrease in oestrogen levels can cause symptoms such as hot flushes, vaginal dryness, mood and sleep changes. If your symptoms are bothering you and you would like to know more about MHT, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms.

Menopausal Hormone Treatment or MHT (also known as Hormone Replacement Therapy or HRT) is the most effective way of improving menopausal symptoms. MHT can also benefit your health by improving bone density and reducing the risk of fractures. MHT may also reduce the risk of a fracture and heart disease for some women. If you have had hormone-dependent cancer, you should not take hormone therapies. Speak with your doctor about other non-hormonal prescription medications.

Types of MHT (HRT)

MHT is available as tablets, patches, gels or vaginal treatments. The type of MHT needed and the associated risks varies according to:

Your doctor can tailor the type of hormone treatment best suited to you. If you had an early menopause you should continue treatment at least until the average age of menopause (51 years).

Oestrogen plus progestogen

If you still have your uterus (have not had a hysterectomy), then you need a treatment that combines oestrogen and progestogen. Progestogens (including norethisterone, medroxyprogester , one dydrogesterone and micronized progesterone) are added to the treatment to reduce the risk of cancer of the uterus. Safety facts:

Oestrogen alone

Oestrogen alone is suitable for women who have had a hysterectomy.

Safety facts:

Vaginal oestrogen therapy

Vaginal oestrogen therapy is useful for women who have local symptoms such as vaginal dryness. Safety fact:

If used as supplied, vaginal oestrogen therapy is safe to use long-term, except after breast cancer.


Tibolone is taken as a single tablet and has some oestrogen, progesterone and testosterone effects. Many, but not all, women find tibolone helps with symptoms and may also improve sexual function. Tibolone is also suitable to reduce the risk of osteoporosis (thinning of the bones) in post-menopausal women.

Safety facts:

Oestrogen combined with a SERM

SERMS (selective oestrogen receptor modulators) are a newer treatment option for menopause. They have anti-oestrogen or oestrogen-like effects that vary in different parts of the body.

A tablet containing conjugate equine oestrogen combined with the SERM bazedoxifene improves menopausal symptoms, bone density and reduces breast density. Bazedoxifene, like progestogen, reduces the risk of cancer of the lining of the uterus in women who have not had a hysterectomy.

Safety fact:

Where can you find information about other treatment options?

If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Other fact sheets about treatment options include:

Information for your doctor to read includes AMS Information Sheets:

If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Doctor service on the AMS website.


AMS Empowering menopausal women

NOTE: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to an individual’s personal circumstances and should always be discussed with their own healthcare provider. This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members, other health professionals and their patients for clinical practice is permissible. Any other use of this information (hardcopy and electronic versions) must be agreed to and approved by the Australasian Menopause Society.

Content updated December 2019