Exploring the real risks and rewards of Hormone Replacement Therapy.
At The Menopause Clinic in Heywood, near Manchester, we understand that deciding whether to begin Hormone Replacement Therapy (HRT) can feel overwhelming. One of the most common concerns women express is around the potential risks associated with HRT – especially when it comes to breast cancer, blood clots, or cardiovascular health.
However, it’s essential to view HRT within the wider context of overall health and lifestyle. When comparing HRT’s small, manageable risks with those posed by obesity, smoking, excessive alcohol consumption and poor diet, a very different picture emerges – one where the benefits of HRT often far outweigh the risks, especially in terms of quality of life.
What is HRT and Who Can Benefit?
HRT replaces the hormones that naturally decline during perimenopause and menopause. These include oestrogen, progesterone and sometimes testosterone. Symptoms such as hot flushes, night sweats, mood swings, low libido, anxiety and brain fog can significantly disrupt daily life – and for many women, HRT offers fast and long-lasting relief.
HRT comes in many forms to suit individual needs, and at The Menopause Clinic we provide the following options:
- Tablets
- Gels
- Patches
- Creams
- Combined treatments or tailored BHRT (Bioidentical Hormone Replacement Therapy)
Understanding the Real Risks of HRT
Decades of research have helped us better understand the risks of HRT – and crucially, how to minimise them. For most women under the age of 60 or within 10 years of menopause, the risks are extremely small.
Some key points:
Breast Cancer Risk
Breast cancer risk is slightly increased with combined HRT (oestrogen and progesterone), but only after five years of use – and the increase is still smaller than the risk posed by being overweight or drinking alcohol regularly. According to a 2009 study by the British Medical Journal, combined HRT (oestrogen and progesterone) increases the risk of breast cancer by approximately 0.2% per year for each year of use after five years. However, this increased risk is small compared to the overall lifetime risk of breast cancer, which is about 1 in 7 women in the UK.
For women using oestrogen-only HRT (typically prescribed to women without a uterus), a 2017 study found that it does not increase the risk of breast cancer and may actually reduce the risk in some cases.
Blood Clots and Stroke Risks
The risk of blood clots or stroke is very low, especially with non-oral forms such as patches or gels. The Royal College of Obstetricians and Gynaecologists (RCOG) states that the risk of blood clots is small for most women on HRT. It is roughly 1-2 per 1,000 women using HRT compared to 2-5 per 1,000 women in the general population, depending on the type of HRT used.
These statistics help put HRT risks in perspective and show that lifestyle factors such as obesity, smoking, and excessive alcohol consumption can have a much more significant impact on overall health than the small, manageable risks associated with HRT when used under medical supervision.
Lifestyle Factors Often Pose Greater Risks
Let’s look at how lifestyle compares:
Obesity vs HRT Risks
According to the World Health Organisation (WHO), obesity is associated with a significant increase in the risk of multiple chronic conditions, including heart disease, stroke, diabetes, and breast cancer. For example, being overweight or obese is linked to an increase in breast cancer risk of about 40% for postmenopausal women.
Smoking and Menopause
Smoking is linked to almost every major chronic illness and increases menopausal symptoms, including earlier onset by around 1-2 years. According to a study published in the Journal of Epidemiology and Community Health (2008), smoking also worsens menopausal symptoms, such as hot flushes. Smokers are at a 50% higher risk of developing osteoporosis than non-smokers, according to a study from the National Osteoporosis Foundation.
Alcohol and Health Risks
Excessive alcohol raises the risk of several cancers, including breast cancer, and can worsen mood and sleep. It is reported that women who consume three or more alcoholic drinks per day have a 15% higher risk of developing breast cancer than women who drink less than one drink per day. Excessive alcohol intake is also associated with lower bone density, a concern for women during menopause, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Diet, Processed Foods, and Long-Term Health Risks
A diet high in processed foods – including fast food, sugary snacks, and foods rich in trans fats and preservatives – can contribute to a wide range of health issues. According to the UK National Diet and Nutrition Survey (NDNS), processed foods now account for around 50% of the average person’s total calorie intake in the UK. Excessive consumption of processed foods is linked to increased risks of obesity, type 2 diabetes, and cardiovascular disease. A 2021 report from the British Heart Foundation (BHF) stated that unhealthy eating habits contribute to around 60% of heart disease in the UK, and processed meats are particularly concerning, with a study revealing that a high intake can increase the risk of heart disease by as much as 42%.
Additionally, poor diet choices can worsen menopausal symptoms such as weight gain, hot flushes, and fatigue, especially when the diet lacks sufficient nutrients such as vitamins D and B12, magnesium, and omega-3 fatty acids, all vital during menopause. The National Institute for Health and Care Excellence (NICE) recommends a balanced diet with minimal processed foods to reduce the risk of long-term health conditions.
Balancing Risk with Quality of Life
One of the most important things we discuss at The Menopause Clinic is the idea of quality of life. For many women, the mental and physical benefits of HRT – better sleep, stronger bones, balanced mood, and renewed energy – greatly improve their day-to-day experience.
We always take time to assess your personal and family history, lifestyle, and treatment goals to determine the safest, most effective form of HRT for you.
Support at Every Stage
At our Heywood-based hormone therapy clinic, we offer both licensed HRT and customised BHRT options, ensuring every treatment is tailored to your unique hormonal needs. Our team of hormone specialists provides ongoing support, regular reviews, and lifestyle advice to help you make informed decisions and feel your best.
Final Thoughts
HRT is not a one-size-fits-all solution, but for many women, it is a lifeline. When managed professionally and combined with a healthy lifestyle, the benefits far outweigh the risks – especially when compared to the more significant dangers posed by obesity, smoking, alcohol, and diet. HRT can support bone density, cardiovascular health, mental clarity, and emotional wellbeing, helping women stay active, productive and confident.
If you’re navigating menopause and unsure about your options, The menopause Clinic is here to help.