Menopause and HRT: The Complete Guide to the Treatment Decision

The Real Numbers, Not the Adjectives

For twenty years women were told hormone therapy caused cancer. More recently they have been told it is safe after all, and that everyone should be on it. Both versions are wrong, and both have cost women either years of unnecessary symptoms or years of unnecessary fear.

This guide takes a different approach. Wherever there is a risk it is given in absolute numbers rather than adjectives, and set beside risks you already understand. Thirty-five pages, nearly 11,000 words, fourteen sections.

Written for this moment

In November 2025 the US authorities announced the removal of the boxed warnings from menopausal hormone therapy, and the revised labelling was approved in February 2026. A great deal of what has been written since overstates what happened. This guide sets out precisely what was removed, what was kept, and why UK labelling has not followed — so you know which country's information you are reading.

What you will find inside

• What HRT is for, and what it is not for — including the claims made online that current guidance does not support
• Every type and route — patches, gels, sprays, tablets and the coil, and why the route changes the risk rather than just the convenience
• Benefits and risks in absolute numbers — the British Menopause Society comparison table, set beside alcohol and other everyday factors
• Vaginal oestrogen — the most under-treated group of symptoms in the whole subject, and a separate question from systemic HRT
• Testosterone — what the global consensus actually supports, and what it does not
• Who cannot take it, and who needs a specialist — including the conditions women are wrongly refused for
• Non-hormonal options — CBT, clinical hypnosis, and the medications with real evidence behind them
• Bone and cardiovascular health, contraception, and the first year of getting the dose right
• When a prescription is refused — what to ask, and what you are entitled to request
• Living with it long term — reviews, stopping, and the questions that come later

Sourced properly

Written from NICE NG23, the BNF, MHRA guidance, NHS information, British Menopause Society consensus statements including the September 2025 breast cancer risk fact sheet, Women's Health Concern, The Menopause Society, ACOG, EMAS and the FDA's own announcements. Glossary and full source list included.

Format: 35-page printable PDF · instant download · UK & US edition

For education only. Not medical advice. No treatment should be started, stopped or altered on the basis of this guide.