Intended for healthcare professionals


Looking at HRT in perspective

BMJ 2022; 377 doi: (Published 15 June 2022) Cite this as: BMJ 2022;377:o1425
  1. Haitham Hamoda, chair,
  2. Sara Moger, chief executive
  1. British Menopause Society, London, UK
  1. Correspondence to: H Hamoda haitham.hamoda{at}

Helping women make informed choices

With average life expectancy in developed countries now exceeding 80, many women will live around a third of their lives after the menopause and may experience related problematic symptoms for several years. This can have a detrimental effect on quality of life, including personal relationships and working life.12

More than 75% of those experiencing the menopause report symptoms, and over 25% describe their symptoms as severe. Average duration of symptoms is seven years, and a third of women have symptoms for longer. The menopause can also have a detrimental effect on bone and cardiovascular health.3

For those seeking help, the National Institute of Health and Care Excellence (NICE) and others124 recommend an individualised and comprehensive approach that includes advice on exercise, optimising weight, stopping smoking, and reducing alcohol consumption as well as management options such as hormone replacement therapy (HRT). The latest evidence for women considering HRT is reassuring, including for all-cause mortality. Assessing the effect on all-cause mortality is particularly relevant as it looks at death as the endpoint for both the benefits and risks.

The main indication for HRT remains control of problematic menopausal symptoms …

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