There’s a growing trend online that’s raising alarm bells. Some influencers are claiming that Hormone Replacement Therapy (HRT) can be used not only to ease menopause symptoms but also as a preventative treatment – for osteoporosis, coronary heart disease (CHD), and even menopause itself. Some even suggest starting HRT before perimenopause to avoid symptoms later.
It’s understandable why these claims are appealing. Most of us would love to avoid hot flushes, brain fog, mood swings, or long-term health risks like heart disease and osteoporosis. But let’s be clear, using HRT as a preventative measure, especially before any symptoms begin, is not recommended and can, in some cases, be harmful.
Social media is not a medical source. Misinformation, even if well-intentioned, can be dangerous. So let’s break down what the evidence actually says about HRT, disease prevention, and the right time to consider it.
What is HRT?
HRT is a treatment, not a preventative drug. It replaces hormones – primarily oestrogen, and sometimes progesterone and/or testosterone – that decline during menopause. Its main purpose is to relieve moderate to severe menopausal symptoms such as hot flushes, night sweats, vaginal dryness, low mood and insomnia.
According to current NICE guidelines, HRT should be offered when menopausal symptoms are affecting quality of life. It is not recommended for those without symptoms or as a tool to prevent menopause itself. There is no evidence to suggest that starting HRT early, before perimenopause, can prevent symptoms later. In fact, starting it too soon may interfere with your body’s natural hormonal rhythms.
HRT is not one-size-fits-all
It’s also important to recognise that HRT isn’t suitable for everyone. Some people can’t tolerate it due to side effects or medical history, while others may not need it at all if symptoms are mild and manageable. In these cases, lifestyle strategies like movement,
mindfulness, dietary adjustments and emotional support (for example, working with a menopause coach) can be very helpful.
HRT, osteoporosis and heart disease
Let’s take a look at osteoporosis first. Oestrogen plays a key role in maintaining bone density, and HRT can help reduce bone loss and the risk of fractures — particularly in early postmenopause. NICE does state that HRT may be considered for osteoporosis prevention in women at increased risk, but only if other medications like bisphosphonates aren’t suitable. It’s not typically prescribed solely for bone protection.
When it comes to heart disease, the picture is a bit more complex. There is some evidence that oestrogen may support cardiovascular health if HRT is started early in the menopausal transition. This is sometimes referred to as the ‘window of opportunity’. But again, HRT is not routinely recommended to prevent heart disease and may even increase risk if started later
in life, especially after the age of 60.
What really works to prevent osteoporosis and heart disease?
The most effective and evidence-backed ways to reduce your risk of these conditions involve lifestyle, not medication. Here’s what helps:
- Strength training to build muscle and stimulate bone growth
- Cardiovascular exercise to support your heart and circulation
- Getting enough calcium and vitamin D to maintain bone strength
- Eating a balanced, whole-food diet with limited saturated fats and sugar
- Quitting smoking and moderating alcohol
- Managing stress and prioritising sleep
These habits are powerful, and they benefit you at every stage of life, including menopause. They also support the effects of HRT, if you’re using it.
The takeaway
HRT can be a game-changer for many women experiencing distressing menopausal symptoms. But it’s not a cure-all, and it’s certainly not something to start early based on what you’ve seen on social media. It should be used for the right reasons, at the right time, and under medical supervision.
If you’re concerned about your symptoms, bone health or heart health, book a chat with your GP. They can advise you on the safest and most effective options based on your individual needs.
Let’s trust the science, not the trends.
Have questions about HRT or menopause health? Feel free to get in touch.