Preparing for a conversation about menopause hormone therapy

Start with what you want help with

Your experience is the starting point for a conversation about menopause hormone therapy (MHT). Bring the symptoms that matter most to you, when they began and how they affect sleep, work, relationships, comfort or daily life. You are welcome to bring questions about particular products or approaches, too.

The 2022 hormone therapy position statement identifies MHT as the most effective treatment for hot flashes, night sweats and genitourinary symptoms. The balance of benefits and risks depends on the formulation, dose, route, timing and individual health history.¹

What to bring to the appointment

• A current list of prescription medicines, over-the-counter products, vitamins, and supplements.
• Relevant personal and family health history, including previous treatments and what happened when you tried them.
• A short record of your most bothersome symptoms and what you hope may improve.
• Questions about cost, access, monitoring, and how you would know whether a plan is helping.
• Your preferences and concerns—even if you are unsure what option you want.

Please tell us about unexplained bleeding, blood clots, heart disease or stroke, liver disease, and hormone-sensitive cancers. These details help us tailor your assessment, discuss suitable options and coordinate further care when needed.¹ You can bring records or ask us which details will be helpful.

Why your health history still matters

The statement includes estradiol and micronized progesterone. WHI studied oral conjugated equine estrogens (CEE), with or without medroxyprogesterone acetate (MPA); its exact risk estimates cannot automatically be transferred to every hormone regimen. Bioidentical options still need an individual assessment.¹

There is time to discuss these questions in your consultation. Tell us what you have read, what you are curious about and anything that worries you; we can review it together.

Questions you can ask

• Which of my concerns could this option address, and which might need a different approach?
• What benefits are realistic for me, and what risks or uncertainties matter given my health history?
• What options are available, including non-hormonal approaches, and how do their trade-offs differ?
• Does my menstrual and surgical history affect which options are appropriate?
• What follow-up should I expect, and when should I contact you sooner?

A decision can be individualized and revisited

Professional guidance supports shared decision-making and periodic review. Factors such as age, time since menopause, symptoms, medical history, and personal priorities can change the balance of potential benefits and risks. The appropriate discussion may also differ for whole-body symptoms compared with symptoms limited to the vaginal or urinary tissues.

You can ask for time to consider your options. You can also ask what is known, what remains uncertain, and what the next step would be if your first choice does not help. Treatment decisions should be made with a qualified clinician who can review your individual circumstances.

Bring your questions and your perspective

You are welcome to bring your own research, ideas and questions. A few notes about your symptoms and what you hope to change can help us make the most of your time together. We will listen to your priorities, explore the options with you and agree on next steps that feel clear and manageable.