Considering Menopausal Hormone Therapy? Experts Decode The Safety & Science

Menopausal Hormone Therapy (MHT) is a science-backed option to manage overwhelming menopause symptoms. Yet, lingering confusion, stigma, and outdated fears continue. At the recent Fabulous Over Forty event in Bengaluru, co-hosted by SheThePeople and Gytree, medical professionals answered some long-standing questions and debunked myths about MHT.

Experts like Dr Sudeshna Ray of the Royal Society of Gynaecs, London, and Jaslok & Reliance Hospital, and Dr Harshitha Jain, a functional medical expert, spoke in detail about MHT. They discussed the science, shattered misconceptions, and answered difficult questions candidly, making women feel informed rather than isolated.

Risks: A 2-decade-old study that changed everything

Dr Sudeshna Ray, in a conversation with Shaili Chopra, the founder of SheThePeople and Gytree, cleared the buzz around MHT, formerly known as Hormone Replacement Therapy (HRT). She explained the stigma surrounding MHT among women in India, revealing that research on the subject remains underreported. 

Dr Ray spoke about a 2002 study by the Women's Health Initiative (WHI), which showed that MHT had harmful side effects that increased the risk of diseases like cancer, dementia, and diabetes. "Multiple newspapers pointed it out and exaggerated the effects, which somewhere instilled the fear of it in its perception," she observed.

Although hundreds of later studies proved that MHT is a safe and scientific treatment option, the fear prevails. Dr Ray explained.

Similarly, Dr Harshitha Jain pointed out that the average age of the participants was 63, and MHT was given 10 years after the subjects entered menopause, which is much later according to the average timings. She also pointed out that the hormone used in the study was a synthetic one called "progestin", not a bio-identical one. 

"Bioidentical hormones have an identical structure to the hormones in the human body. It is like a supplement rather than a synthetic drug," Dr Jain explained. 

Dr Jain said that even the US Food and Drug Administration (FDA) has acknowledged these gaps. "The situation has been so much better since then. Last year, the FDA also eliminated the warning of breast cancer on MHT," she revealed.

Who can take MHT?

Talking about medical guidelines and procedures, Dr Sudeshna Ray revealed that medical professionals rarely prescribe MHT as the first treatment choice. "Menopause is natural, so it is better to take care of the symptoms with lifestyle changes like exercise, diet, psychological counselling, or supplements," she said. 

Dr Ray added that MHT is prescribed in cases where the symptoms are overwhelming and interfering with daily life, productivity, or relationships. She also cleared another misconception, emphasising that MHT is only used to regulate hormones; it is not a "magic pill" that can make a person look or feel young.

How is MHT prescribed? 

Dr Harshitha Jain spoke about the four Ps of Hormone Therapy:

Precise – Selecting the appropriate type of hormone and administering it in the correct dosage. Using 'bio-identical hormone', something which is similar to the structure of our own hormones.

Personalised – Designing the treatment according to a woman’s specific symptoms, medical history, and overall risk profile.

Preventive – Supporting bone mineral density and helping reduce the risk of fractures.

Predictive – Continuously monitoring through lab tests and symptom assessment to determine when to adjust the dose or discontinue therapy, to avoid complications later.

Understanding MHT 

The conversations at Fabulous Over Forty made one thing clear: Menopausal hormone therapy (MHT) should be viewed with clarity rather than fear. It is not a one-size-fits-all solution, nor is it something to accept or reject blindly. 

When prescribed thoughtfully, monitored carefully, and tailored to an individual’s needs, MHT can significantly improve quality of life by managing symptoms and supporting long-term health, especially bone strength. The key lies in informed decision-making and open conversations.

Views expressed by the author are their own.