HRT for menopause may not help with mental health or sleep says a large 2026 analysis

There are multiple HRT options to treat menopause and perimenopause symptoms including hot flashes, vaginal dryness, and mood swings.

Within months of a landmark 2002 study that indicated HRT harms, sales dropped by about half

In the early 2000s, Women's Health Initiative studies indicated HRT increased risk of breast cancer, heart disease, and stroke in some women—so many physicians stopped prescribing it to help with menopause symptoms. But further research has concluded that much of the elevated risk was overblown and that it was also disproportionately seen in women in their 70s who had been taking an older HRT formulation.

27% of US menopausal women used estrogen in 1999, but by 2020 that number was under 5%

The fallout of studies in the early 2000s linking hormone therapy for menopause and elevated cancer, stroke, and other health risks meant that even decades later—yet before the FDA removed its black box warning in 2025—use of HRT remained extremely uncommon. (Some users may experience a paywall.)

HRT patches are popular partly because they have lower blood clotting risks than oral estradiol

Women taking estradiol for menopause or perimenopause are sometimes told oral HRT is not an option for them because it increases blood clot risks. But a large analysis in 2019 concluded that other forms of the HRT, such as the patch, creams, and gel, do not.

How menopause affects mental health

Menopause, a natural biological process, occurs in three stages: perimenopause (hormone fluctuations), menopause (end of menstrual cycles), and postmenopause (12 months without menstruation). Hormonal shifts during this time can affect neurotransmitters, increasing the risk of mood disorders.

The gaps in menopause research and their effects

Nearly all studies (99%) researching the biology of aging don’t consider menopause in their setup. A Harvard professor noted that about 75% of aging-related diseases are likely influenced by menopause. In this article, she discusses how gaps in research are negatively impacting how the medical system can effectively treat aging women. Read her analysis of the issue here.

FDA has removed black box warnings from hormone replacement therapy for menopause.

Menopause can exacerbate anxiety

Some research shows that menopause can fuel anxiety and also that preexisting anxiety can boost the chances of experiencing other menopause symptoms, including hot flashes, insomnia, and brain fog. But treatments—including hormone replacement therapy, breathing exercises, and other forms of exercise—can alleviate some of these symptoms.

Common hormone therapies to treat menopausal symptoms

While there is no cure for menopause, there are ways to treat some of the intense symptoms women experience during perimenopause. There are two main hormone therapies used, one in the form of a pill, gel, or patch to treat symptoms like hot flashes, and another in the form of a cream or ring to treat symptoms like vaginal dryness. Read this article to learn more about the different hormone therapies available for menopausal women.

It's never too late to start hormone replacement therapy for menopause symptoms because the products may help alleviate symptoms of menopause or fight bone loss.

MS Drugs reduce inflammation, helping reduce relapses and slow disease progression

Disease-Modifying Drugs calm the body's inflammatory response to help stave off relapses—when new or existing MS symptoms show up for a day or longer. Avoiding smoking, exercising, reducing stress via mindfulness, checking for vitamin D deficiencies, drinking more water and eating well, all can slow disease progression. [The jury's still out on if HRT around the time of menopause may reduce dementia risk](https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(25)00122-9/fulltext) Estrogen can reduce inflammation and support neural growth in the brain, and some research has suggested that beginning hormone replacement therapy around menopause—versus later in life—reduces Alzheimer's disease risk. Still, a recent systematic review concluded that taking HRT didn't affect dementia risk, regardless of when women started taking it, so the science remains unsettled.

Menopause hormone therapy infuses the body with estrogen after the body's natural levels drop

The treatments can treat symptoms like hot flashes and vaginal dryness at varying doses. Progestogen, another hormone, is also typically prescribed with estrogen because estrogen alone can thicken the uterus lining, which elevates the risk of developing endometrial cancer.

Gender-affirming hormone therapy cues changes similar to puberty

When HRT is part of gender affirmation care, people receive regular doses of estrogen or testosterone to alter hormone levels to more closely align with those of cis individuals of that biological sex. HRT may affect voice pitch, body hair, bone density, and more. Many of those changes are not reversible with the cessation of therapy, though the effects may diminish.

Menopause affects the brain in complex ways

Lisa Mosconi, a neuroscientist studying the impact of menopause on the brain, explains in this video how menopause directly impacts a woman's brain health and explores why this is an important and often overlooked area in menopause and women's aging healthcare discussions.

Menopause and perimenopause symptoms may affect both the mind and the body

Women going through these aging transitions may experience some common physical and mental symptoms to varying degrees, including hot flashes, bladder control issues, brain fog, and vaginal dryness. This article dives into some of the most common symptoms women might expect during perimenopause, plus what they can do to relieve them.

America doesn't have enough estradiol patches for menopause and perimenopause demand

Fueled in part by the lifting of the FDA's black box warning about HRT risks, sales of estradiol patches in the US have shot upward. More than 142 million units of the patches were sold in 2025 versus 46.5 million in 2020. Suppliers are failing to keep up with demand—11 patch products were in short supply in early 2026. (Some users may experience a paywall.)

Less than 1% of aging studies consider menopause and its effects

Nearly all studies researching the biology of aging don't consider menopause in their setup. In part, that's because menopause is difficult to emulate in animal models. Menopause is uncommon in the animal world beyond humans and whales. This presents a problem for medicine and science because about 75% of aging-related diseases are likely influenced by menopause.

Menopause may become a $600B industry

Companies marketing products and supplements to alleviate menopause symptoms and make life easier during this life stage have become a gold mine. This 2022 article explores how and why companies have swooped into this space, and whether you should trust them or not.

A 40-something science journalist was getting more winded during workouts, and experiencing night sweats, forgetfulness and tiredness—she thought it was perimenopause, but these common symptoms turned out to be signs of her blood cancer.

Health problems are being misdiagnosed as perimenopause symptoms

Symptoms of menopause and perimenopause (the premenopause period) can be varied enough that clinicians dismiss them in patients in their mid-30s and onward as just a symptom of hormone level change. In this story, a woman's itching was dismissed as a hormonal change, but after two years and 11 separate doctor consultations, was diagnosed as cancer. (Some users may experience a paywall.)

86 commonly used drugs, including certain antidepressants, painkillers, and immunosuppressants, have different results for men and women, according to recent research.

By 2030, roughly 6% of the world's population will be in menopause

An estimated 25 million women pass through menopause annually, with a projected increase in the number of women in menopause in both lower-resource and higher-income populations in the years ahead, highlighting the social and economic value of focusing on menopause care.

Menopause is a hormonal transition point, like puberty

Yet menopause isn't talked about as much. In this podcast episode by Houston Methodist, a Texas-based hospital, the host speaks with a gynecologist with a specialization in menopausal medicine about what menopause really is, and how women and the people in their lives can navigate this next life stage.

Late-onset menopause lowers osteoporosis risks, but heightens the risks for certain cancers

Defined as when a woman starts to experience perimenopause after age 55, late-onset menopause is linked to an elevated risk of developing breast, ovarian, and uterine cancers.

Scientists have not yet answered what the evolutionary benefit may be of menopause

Few animals are known to experience menopause, raising questions about why it would be evolutionarily advantageous to have women survive past their reproductive years. One leading hypothesis is the grandmother hypothesis—older women and other species known to experience menopause, like whales, can aid families and pass down knowledge to future generations.

Perimenopause, which typically occurs in a woman's mid-40s, precedes menopause

Sometimes referred to as the menopausal transition, perimenopause often lasts around four years as the ovaries' production of the reproductive hormones progesterone and estrogen decline. It may be accompanied by mental and physical symptoms, including irregular periods, hot flashes, sleep issues, mood swings, and alterations to a woman's sex drive.

This is what happens to your body during menopause

The menopause transition may begin in one's mid-40s with erratic periods and a decrease in estrogen. It can trigger health complications, including hot flashes, palpitations, and elevated risks of osteoporosis.

What is medical menopause?

Medical menopause is when menopause is induced from either surgery or medicine. Chemotherapy and radiation, as well as oophorectomy (a surgical procedure that removes the ovaries) and a radical hysterectomy can cause a woman to become menopausal. Women that go through medical menopause experience the same symptoms as women that experience natural menopause. Learn more about the medical condition here.

Premarin was the bestselling drug in the US in 1992

The drug, derived from the urine or pregnant mares, raised ethical and animal welfare concerns, but also became wildly popular until the Women's Health Initiative study findings in 2002 (which have since been largely disproved). In the 1990s, Premarin was used to treat menopause symptoms and also to protect against osteoporosis and heart disease among older women.

Treatment-induced menopause is menopause induced by surgery or medicine

Chemotherapy and radiation, as well as oophorectomy (a surgical procedure to remove one or both ovaries) and a radical hysterectomy, can cause a woman to become menopausal. Women who go through medical menopause experience the same symptoms as women who go through menopause caused by natural hormonal cycles.

Women experience heightened bone loss after menopause

Both women and men begin to lose some bone density after age 35, on average. But, for the first decade after menopause, women lose bone more rapidly due to the significantly decreased levels of estrogen, putting women at heightened risk of osteoporosis and related bone fractures.

Estrogen is a really important hormone for men, too.

Menopause, once not discussed in polite company, is now a plot point in some television shows

Menopause has long been a topic left out of film and TV. But some shows, like "The Change," and celebrities, like Jennie Garth, are now openly talking about it. This article breaks down how Hollywood is starting to come around to the menopause conversation and how celebrities are talking about their own personal experiences, as well as advocating on Capitol Hill.

It's been about 30 years since a new hair loss drug was approved in the US, and women currently have no approved pills for hair loss.

Circadian rhythm disruption can influence various mental health disorders

This 2020 research overview surveys the relationship between disrupted circadian clocks and disorders including schizophrenia, anxiety, and bipolar disorder. It incorporates findings and therapeutic approaches drawing from human night shift studies and jet lag studies alongside animal research.

Perimenopause can last as long as 8 years

Perimenopause typically lasts about four years, beginning at around age 45; however, some women experience it as early as their 30s. Smoking and thyroid disease are factors that can trigger early perimenopause. Early menopause, which can increase health risks, occurs in about 5% of women. Researchers are still investigating why it occurs.

External factors, not aging itself, lead to sleep loss in older adults

Though it is often believed that people need less sleep as they age, the recommended sleep guidelines for all adult age groups are almost identical. However, factors such as medication use, lack of physical activity, and loneliness can lead to sleep problems, and thereby lead older people to believe that they actually need less sleep than they do.

Postmenopause is a stage lasting roughly a third of a woman's life

Postmenopause is the final stage of menopause, occurring once a woman hasn't had any vaginal bleeding for a full year. She is then considered postmenopausal for the rest of her life. While some of the intense symptoms she might experience during postmenopause will decline, her risk for certain conditions and diseases will increase.

The overlooked physical causes of insomnia

Persistent lack of sleep is dangerous for anyone, but women are especially unlikely to have their symptoms taken seriously. This article highlights the physical causes of insomnia—a condition often written off as solely psychological—and the importance of early diagnosis. The writer, Courtney Maum, was diagnosed with an anterior nasal valve collapse as the source of her insomnia.

Men are flocking to hundreds of new online testosterone clinics for low T prescriptions.

Menopause is defined as 12 months without a period

Menopause is officially when a woman stops getting her period, meaning she has stopped ovulating and can no longer get pregnant. A woman has to go a full year without bleeding or spotting to know she has hit menopause.

FDA removed its cardiovascular risk warning on testosterone products in 2025

The change came a decade after the FDA added the label. Recent work, including a gold-standard randomized trial, found that men receiving the products had similar cardiovascular risk levels as men taking placebo products. Testosterone, however, may hold other health risks, including infertility.

Temperature and certain medications can also affect your circadian rhythms

Although light and dark have the largest influence on circadian rhythms, temperature, stress, and certain medications are among the factors that also play a role. Persistent trouble sleeping or staying asleep may signal it’s time to see your doctor to get a better sleep-wake schedule.

Early menopause, occurring before age 45, can be triggered by certain risk factors

Some potential causes of early menopause include autoimmune disorders, chemotherapy, smoking, and certain surgeries that cause the body to produce lower levels of estrogen and progesterone.

Women are four times as likely to be diagnosed with seasonal depression

This prevalence trend mirrors the broader incidence of depression among women and is well-documented. Researchers suggest the disparity stems from differences in hormones, social role expectations, coping mechanisms, and more. Men may also present with depression differently, and seek help less.

Psychedelic side effects, including worsening mental health for some patients, give pause

This article explores whether the therapeutic potential of psychedelic drug use is really as good as current research suggests. Scientists are exploring its applications for conditions ranging from the existential crisis that can accompany terminal diagnoses to chronic mental health conditions, including anxiety and PTSD.

Emerging research suggests that cannabis, used by about 9% of American adults as a sleep aid, may suppress rapid eye movement and lead to worse quality sleep and fewer remembered dreams.

Yoga is believed to improve mental health, but studies are not definitive

Many think that yoga's combination of stretching, focused breathing, and contemplation help treat depression and anxiety, but the data has often relied on small, homogenous sample sizes.

Obsessing over sleep metrics leads to worse sleep quality

Over one-third of Americans have used wearable technology to track their sleep, and the anxiety over having perfect sleep data, or orthosomnia, has made getting a good night's sleep more difficult. Experts agree that most devices cannot correctly assess sleep details, making the data unreliable.

Inflammation appears to cause specific symptoms of depression

A large analysis of existing studies published in 2021 found that systemic inflammation is associated with fatigue, appetite changes, and sleep disruption, rather than some of depression's broader symptoms including hopelessness about the future, or feeling fearful. This may suggest that inflammation influences specific symptoms of the condition, rather than the disease as a whole.