Hormone therapy is especially helpful for women who are experiencing menopausal symptoms like hot flashes, night sweats, and mood swings, which are associated with decreased estrogen and progesterone levels. Women with early menopause or conditions like premature ovarian insufficiency also benefit from hormone therapy, as it helps prevent long-term risks such as osteoporosis and cardiovascular disease that can arise from early estrogen loss.

Estrogen plays a key role in maintaining bone density by reducing the activity of osteoclasts, which are cells that break down bone. During menopause, declining estrogen levels accelerate bone loss, increasing the risk of osteoporosis and fractures. Hormone therapy can slow down this bone loss and, in some cases, improve bone density. Starting therapy around menopause is particularly effective, but even short-term use in older women can have lasting positive effects on bone health.

When used appropriately, hormone therapy is generally safe, especially for women who begin treatment around the time of menopause. For women who begin HT around the time of menopause (before age 60 or within 10 years of menopause onset), the benefits often outweigh the risks, as hormone therapy can relieve symptoms and provide preventative health benefits. However, longer-term use can slightly increase risks of breast cancer, blood clots, and stroke, with oral therapies carrying higher risk than non-oral options like patches or gels. Women with higher health risks may find non-oral options to be safer.

Symptom relief often begins within days to weeks, especially for hot flashes and night sweats. Mood stability and improved sleep quality may take a few months. The protective effects on bone density develop over a longer period and may require continuous use for best results.