Hormone Therapy in 2026: The Evidence-Based Guide
Hormone replacement therapy (HRT) has had a turbulent history — praised, then vilified after a flawed 2002 study, then rehabilitated as researchers understood the data better. Today, medical consensus from major organizations including NAMS (North American Menopause Society) and The Endocrine Society supports HRT as safe and effective for most healthy women under 60 experiencing significant menopause symptoms.
Types of Hormone Therapy
Estrogen Therapy (ET)
For women who have had a hysterectomy. Available as pills, patches, gels, sprays, vaginal rings. Most effective treatment for hot flashes, night sweats, sleep disruption, and vaginal dryness. Also protective of bone density.
Combined Estrogen + Progesterone (EPT)
For women with a uterus — progesterone protects the uterine lining from estrogen-driven overgrowth. Modern bioidentical progesterone (micronized progesterone/Prometrium) has a better safety profile than older synthetic progestins.
Testosterone Therapy (Men)
For men with clinically low testosterone (hypogonadism) — symptoms include fatigue, low libido, muscle loss, depression, brain fog. Available as injections, gels, patches, pellets. Requires blood work confirmation before prescribing.
Testosterone for Women (Low-Dose)
Off-label but increasingly supported — low-dose testosterone in women improves libido, energy, and muscle tone. Prescribed at roughly 1/10th the male dose.
Hormone Therapy Costs
| Treatment | Monthly Cost | Notes |
|---|---|---|
| Estrogen patch/gel | $30–$80 | Often covered by insurance |
| Bioidentical HRT (compounded) | $80–$200 | Rarely covered; customizable |
| Testosterone injections (men) | $40–$100 | Often covered; self-administered |
| Pellet therapy (men or women) | $300–$600/insertion (3–6 months) | Convenient but not reversible |
| Initial consultation + labs | $150–$400 (one-time) | Blood work required |
Find a Hormone Therapy Provider
Look for providers with training in endocrinology, menopause medicine, or integrative medicine. Always require baseline blood work before starting treatment.