Estrogen replacement therapy (ERT), often called hormone replacement therapy (HRT), helps replace the estrogen your body stops making after menopause or surgery. If you’ve been woken by hot flashes, dealing with night sweats, or noticing vaginal dryness and low libido, estrogen can help. It also helps slow bone loss, which lowers fracture risk for some women.
You can get estrogen several ways. Pills and transdermal patches provide systemic estrogen that affects the whole body and ease hot flashes and night sweats. Gels and sprays work similarly but some people prefer them to pills. Vaginal rings, creams, or tablets apply estrogen locally and are best for vaginal dryness, painful sex, and recurrent urinary symptoms without giving a large dose to the rest of the body.
Systemic estrogen usually needs a progestin added if you still have a uterus. That combination lowers the risk of uterine lining overgrowth. If you’ve had a hysterectomy, estrogen alone may be an option. Your doctor will explain which route and dose fit your needs.
Benefits are clear: faster relief from hot flashes, fewer night sweats, better sleep, improved vaginal comfort, and protection for bone density. But there are trade-offs. Systemic estrogen can raise the risk of blood clots and stroke, and combined estrogen-progestin has been linked to a small increase in breast cancer risk in some studies. Certain health conditions make estrogen unsafe—active liver disease, recent blood clots, or unexplained vaginal bleeding are examples.
Start with the lowest effective dose and review treatment each year. Many people use ERT for a few years until symptoms ease, while others need longer treatment; this is a personal choice made with your clinician. Regular checks—blood pressure, breast exams, and age-appropriate screening like mammograms—help spot problems early.
If you prefer to avoid hormones, non-hormonal options exist. Low-dose vaginal moisturizers and lubricants help vaginal symptoms. For hot flashes, certain antidepressants, gabapentin, and lifestyle changes (cooling measures, exercise, weight control) reduce symptoms for some people.
Before you start ERT, talk openly with your provider about personal and family health history, current medicines, and your priorities. Ask which form of estrogen fits your goals, how long to try it, and what signs should prompt a follow-up visit.
Want more reading? Our hub covers related meds, safety tips, and how to buy prescription treatments safely. If you’re shopping or comparing options, use those resources and talk to your pharmacist or doctor to make the choice that fits your life and health.
