MHT is often discussed as either “safe” or “dangerous” but the real clinical picture is far more nuanced.

In Episode 7 of our menopause series, we unpack the major risks associated with menopausal hormone therapy, including breast cancer, venous thromboembolism, stroke and cardiovascular disease, and explore how age, timing, route of administration and the specific hormone regimen all influence risk.

We revisit the Women’s Health Initiative and why its findings changed menopause prescribing for a generation, while also explaining why those results cannot simply be applied to every woman using contemporary MHT.

We also cover complex clinical situations including migraine, hypertension, liver disease, previous cancer, unscheduled bleeding and starting or continuing MHT later in life.

And for women who cannot or do not want to use hormone therapy, we look at non-hormonal options including fezolinetant (Veoza), its mechanism of action and the important liver-monitoring requirements clinicians need to know.

This episode is about moving beyond blanket reassurance or blanket fear, and towards individualised, evidence-based risk assessment and shared decision-making.


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