Debunking Common HRT Myths

Hormone Replacement Therapy (HRT) is one of the most effective treatments for managing symptoms caused by declining hormone levels. Unfortunately, outdated studies, misinformation, and decades-old media headlines have created persistent myths that continue to make women—and men—hesitant about hormone therapy.

Modern research paints a very different picture. Below, we break down the most common myths about HRT using current medical evidence.

Myth 1: “HRT Increases Heart Attack Risk.”

Not true.
For healthy women under age 60 or within 10 years of menopause onset, HRT does NOT increase heart attack risk (The North American Menopause Society, 2022)¹.

In fact, estrogen therapy can provide cardiovascular protection when started earlier in the menopausal transition (Manson et al., 2017)².

Important distinctions

• Pill forms may carry a slightly higher stroke/DVT risk.

• Transdermal HRT (patch, gel, cream) bypasses the liver and significantly reduces these risks.

At Hormone Treatment Centers, women over 60 undergo a personalized cardiovascular risk assessment to determine whether HRT is appropriate and safe.

Myth 2: “HRT Causes Breast Cancer.”

This is one of the oldest and most widely misunderstood myths.

The fear originated from early 2000s studies using synthetic progestins, not bioidentical progesterone.

Current evidence says:

• Estrogen-only HRT does NOT increase breast cancer risk and may slightly reduce it (Chlebowski et al., 2020)³.

• Combined HRT with synthetic progestins may slightly increase risk depending on duration.

• Bioidentical progesterone is associated with a neutral or lower breast cancer risk compared to synthetic progestins (Stute et al., 2018)⁴.

HRT does not cause new cancer, but any hormone—natural or prescribed—can stimulate cancer cells that already exist. Screening and monitoring ensure safe therapy.

Myth 3: “HRT Has the Same Risks as Birth Control.”

Incorrect.

Birth control pills contain much higher hormone doses designed to suppress ovulation. HRT uses fractional, physiologic doses that restore hormone levels—not override them.

Therefore, HRT:

• Does not carry the same clotting risks as high-dose contraceptives

• Does not suppress the reproductive cycle

• Is safer for long-term use in midlife women (NAMS, 2022)¹

Myth 4: “HRT Causes Blood Clots.”

Only partially true.

The pill form of HRT can slightly increase clotting risk—especially in women with existing clot risk factors.

However:

• Transdermal estrogen (patch/gel) has no significant increased risk of clots (Vinogradova et al., 2019)⁵.

At HTC, we primarily use non-oral estrogen to minimize clotting risks while maximizing symptom relief.

Myth 5: “HRT Can Only Be Taken for Five Years.”

No evidence supports this.

Women can safely remain on HRT as long as needed, provided they are using:

• The lowest effective dose

• Under medical supervision

• With routine monitoring

Modern guidelines confirm long-term HRT is safe for the right patients and should be individualized rather than time-limited (NAMS, 2022)¹.

Myth 6: “HRT Delays Menopause.”

False.

Menopause is the permanent end of ovarian hormone production. HRT does not delay, reverse, or pause menopause—it simply treats symptoms and improves quality of life.

When it’s time to discontinue, dosing is gradually tapered to support a smooth and comfortable transition.

Myth 7: “HRT Causes Weight Gain.”

HRT does not cause weight gain.

Midlife weight changes come from:

• Slowed metabolism

• Loss of muscle mass

• Hormonal shifts

• Genetic changes in fat distribution

HRT may actually help stabilize body composition by maintaining lean mass, improving sleep, and supporting metabolism (Franco et al., 2022)⁶.

Weight gain during HRT is coincidental—not caused by the therapy.

Ready to Start Your HRT Journey?

If hormone imbalance is impacting your daily life, sleep, mood, or metabolism, our expert providers at Hormone Treatment Centers can help. We offer personalized, clinically guided HRT for both men and women.

Contact us today to learn more and schedule your consultation.

Peer-Reviewed Works Cited

1. The North American Menopause Society. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794.

2. Manson, J. E., et al. (2017). Menopausal hormone therapy and long-term health outcomes. JAMA, 318(10), 927–938.

3. Chlebowski, R. T., et al. (2020). Estrogen-alone therapy and breast cancer incidence. Journal of the National Cancer Institute, 112(1), 31–39.

4. Stute, P., Wildt, L., & Neulen, J. (2018). The impact of micronized progesterone on breast cancer risk. Climacteric, 21(2), 111–122.

5. Vinogradova, Y., Coupland, C., & Hippisley-Cox, J. (2019). Extra risk of venous thromboembolism with different types of hormone replacement therapy: A large UK study. BMJ, 364, k4810.

6. Franco, O. H., et al. (2022). Menopause, hormones, and metabolic health: Updated evidence. Nature Reviews Endocrinology, 18(3), 173–188.