HRTs

Hormone replacement therapy (HRT) encompasses medical treatments that replace or modulate hormones in the body. It is used to address hormone deficiencies or imbalances and to support medical conditions ranging from menopausal symptoms to gender-affirming care. HRT can involve estrogens, progestogens, androgens, or thyroid hormone, and it may be delivered by pills, patches, injections, implants, or topical applications.

Common indications include relief of vasomotor symptoms and prevention of bone loss in menopause; gender-affirming hormone therapy to align secondary sexual characteristics with gender identity; and replacement in hypogonadism or pituitary disorders where hormone production is insufficient.

Estrogens are often given with progestogens in people with a uterus to reduce endometrial cancer risk; testosterone is used for transgender men or people with testosterone deficiency; in certain conditions, thyroid hormone is used to substitute for hypothyroidism. Routes include oral, transdermal, injectable, and topical forms.

Benefits include symptom relief, improved bone density, and reduced risk of certain complications when used appropriately. Risks vary by hormone type and dosing and may include blood clots, cardiovascular events, cancer risks, liver effects, weight changes, and mood effects. Therapy is generally individualized and periodically reassessed.

Patients are typically evaluated before starting HRT with history, physical exam, and baseline labs; treatment is later monitored with follow-up visits, symptom check, and selective testing. Contraindications include active hormone-sensitive cancers, history of thromboembolism, substantial liver disease, and pregnancy. Dosing and duration aim for the lowest effective amount.