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Hormone Replacement Therapy and Breast Cancer Risk: What Women Need to Know

Written by healthwords.ai's team of doctors and pharmacists based in UK | Updated: 01 Dec 2025 | 4 min read

Hormone Replacement Therapy, or HRT, is a treatment that helps women manage symptoms of menopause, like hot flashes, mood swings, and bone health issues. HRT can improve life during menopause, but it may slightly raise the risk of breast cancer. Knowing how HRT affects breast cancer risk helps women make smart choices for their health.

What is HRT?

HRT replaces estrogen, a hormone that drops during menopause. This drop can cause symptoms like night sweats and mood changes. HRT helps balance hormones and relieves these symptoms.

Types of HRT:

  • Estrogen-only HRT: Usually for women who have had their womb removed. Using it with an intact womb can raise the risk of womb cancer.
  • Combined HRT: Has both estrogen and progesterone. For women with a womb, it lowers womb cancer risk but may slightly raise breast cancer risk more than estrogen-only HRT.
  • Localized HRT: Creams, rings, or tablets used in the vagina for dryness. It does not affect the whole body.

HRT and Breast Cancer Risk

Some studies show that combined HRT can slightly increase breast cancer risk, especially if used for a long time.

Risk factors include:

  • Type of HRT: Combined HRT has a higher risk; localized HRT does not.
  • Duration: Using HRT for longer periods, especially combined HRT, can increase the risk. Regular check-ins with your doctor are recommended.
  • Personal/family history: If you or your family have had breast cancer, the risk may be higher.

Most research indicates that the risk returns to normal within five years of stopping HRT. Many women still find that HRT improves their quality of life.

Factors That Affect Breast Cancer Risk

  • Age: Starting HRT closer to menopause is associated with lower risks. Starting later can increase risk.
  • Family history: Women with a family history of breast cancer should talk to their doctor.
  • Lifestyle: Smoking, alcohol, and being overweight raise breast cancer risk. Healthy habits help lower risk.
  • Duration of use: Short-term use (under five years) has less impact; more prolonged use may increase risk.

Alternatives to HRT

HRT isn’t right for everyone. Other ways to manage menopause symptoms include:

  • Lifestyle changes: Exercise, healthy eating, and less alcohol can help. Relaxation methods like yoga or mindfulness may also help.
  • Non-hormonal medicines: Some antidepressants can help with hot flashes and mood changes, even in low doses.
  • Herbal supplements: Some women try black cohosh, red clover, or evening primrose oil. Always check with your doctor or pharmacist before starting any supplement.
  • Cognitive Behavioral Therapy (CBT): This talking therapy can help with hot flashes, night sweats, and mood changes.

By combining these approaches, many women find they can manage menopausal symptoms safely and effectively without HRT.

Staying Healthy While on HRT

  • Yearly check-ups: Review symptoms and adjust HRT as needed.
  • Breast checks: Self-checks and regular mammograms for women over 50 or at higher risk.
  • Healthy habits: Eat well, exercise regularly, and limit alcohol consumption.
  • Mental health: Talk to your doctor if you notice mood changes or anxiety.

Weighing the Benefits and Risks

For many, the decision to start or continue HRT can be hard. To make the best choice, here are some important points to consider:

  • Better quality of life: HRT helps many women manage tough menopause symptoms and stay active.
  • Stronger bones: Estrogen in HRT helps prevent osteoporosis after menopause.
  • Cancer risk: HRT can slightly raise the risk of some cancers, but for many, the relief from symptoms is worth it.
  • How long you use it: Using HRT for less than five years is usually safe for most women. Longer use needs more careful monitoring.

Making the Right Choice for You

Choosing to begin, continue, or stop HRT is a personal decision and involves weighing the benefits and potential risks. Here’s how to approach this decision:

  • Talk with your doctor: Share your symptoms and health goals. Your doctor can help you decide what’s best.
  • Think about family history and lifestyle: These can affect your HRT choices.
  • Check other health risks: Some women may need other treatments instead of HRT.
  • Stay informed: New research can change what we know about HRT and menopause care.

When to See a Doctor

See your doctor if:

  • Your menopause symptoms are severe or don’t go away.
  • You have a family history of breast cancer or other hormone-related cancers.
  • You have been on HRT for a long time (over a year).
  • You notice new health problems, like breast changes, lumps, or ongoing pain.

Regular check-ups ensure HRT is safe and effective.

Conclusion

HRT can help many women manage menopause symptoms, but it’s important to know both the benefits and possible risks. Regular doctor visits, healthy habits, and staying informed help women make the best choices for their health and comfort during menopause.

This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.