Hormone replacement therapy (HRT) has been through a 25-year reputation cycle — from default prescription to feared, and back to mainstream. The right answer for you depends on your symptoms, your personal risk profile, and a few key markers most GPs don't run first.
What HRT actually treats
HRT is most useful for vasomotor symptoms (hot flushes, night sweats), urogenital symptoms (vaginal dryness, urinary issues) and bone protection. It also helps mood and sleep for many women — but the effect there is more variable.
What to test before the conversation
Walking into an HRT consult with the right bloodwork in hand cuts weeks off the process:
- •FSH and estradiol (baseline)
- •Full thyroid (TSH, free T3, free T4, antibodies)
- •Lipids (cholesterol breakdown)
- •HbA1c and fasting insulin
- •Vitamin D, B12, ferritin
- •Liver function
Body-identical vs synthetic
Modern HRT typically uses body-identical estradiol (often transdermal) and micronised progesterone — chemically the same molecules the body makes. This is what most women's-health specialists prescribe today, and the risk profile is meaningfully different from the older synthetic combinations the WHI study looked at.
Who should be cautious
Personal history of hormone-sensitive cancer, active liver disease, unexplained vaginal bleeding, or recent VTE — these are real contraindications. Family history of breast cancer is a discussion, not a blanket no. we help you frame the conversation (Robyn available for an optional consult); the prescribing decision sits with your doctor.
Frequently asked
No — we're a testing and protocol service. We give you the bloodwork and the framing; prescribing sits with a registered prescriber.
Yes. we'll tell you which markers are useful on HRT and which to interpret with caution.