ACOG recommends hormone therapy as first-line treatment for menopause symptoms

The American College of Obstetricians and Gynecologists has issued new guidelines that place hormone replacement therapy (HRT) at the forefront of treatment for common menopause and perimenopause complaints like hot flashes, night sweats, and sleep disturbances. Kameelah Phillips, an OB-GYN menopause specialist, explained that earlier advice often suggested antidepressants, exercise, or modest alcohol use, which offered limited relief.

HRT can be administered through various formats, including oral tablets, transdermal patches, nasal sprays, gels, or a vaginal ring, and low-dose vaginal estrogen may benefit some patients. The recommendations caution against HRT for women with a history of blood clots, stroke, liver disease, or breast cancer, referencing a 2002 study linking hormones to higher breast-cancer risk in older women. Recent research involving more than 10,000 participants suggests that age and dosage can make HRT safe for many. The guidelines advise initiating therapy before age 60 or within ten years of menopause onset, and they encourage consultation with menopause-trained clinicians for alternative non-hormonal options when HRT is unsuitable.