Hormone therapy
Menopause Hormone Therapy in Quebec
Wondering whether hormone therapy might be one of the options worth considering for your perimenopause or menopause symptoms?
Menopause hormone therapy (MHT) — still widely known as hormone replacement therapy, or HRT — can be an effective option for some women, particularly when hot flashes, night sweats, disrupted sleep, or intimate symptoms are affecting quality of life. It is not the right fit for every situation, however.
At Pause Claire, the consultation helps you better understand the possible benefits, the risks, the precautions worth weighing, and the options suited to your situation, through a personalized and evidence-based approach.
What is menopause hormone therapy?
Menopause hormone therapy uses hormones — primarily estrogen, combined with a progestin or progesterone depending on the clinical situation — to relieve certain symptoms linked to the menopausal transition.
There is a distinction between systemic hormone therapy, which acts throughout the body, and locally acting hormone therapy; that distinction is discussed further below. Systemic options fall into three categories: so-called bioidentical hormones, conventional hormones (conjugated estrogens, medroxyprogesterone acetate, and other progestins), and other hormonal agents (bazedoxifene combined with conjugated estrogens, and tibolone).
Menopause hormone therapy can be taken in several forms, including transdermal, oral, and vaginal routes. The right choice depends on your symptoms, your health history, your risk factors, your preferences, and your own goals.
Which symptoms can hormone therapy relieve?
- Hot flashes
- Night sweats
- Sleep disruption linked to vasomotor symptoms
- Vaginal dryness or intimate discomfort
- Pain during sex
- Certain urinary symptoms linked to the genitourinary changes of menopause
- Quality of life affected by symptoms of the menopausal transition
Hormone therapy is not a single answer to every symptom. Some symptoms have more than one cause, and an assessment helps clarify what is actually contributing to your situation.
Is hormone therapy safe?
Hormone therapy is not one single treatment. There are several types of hormones, formulations, doses, and routes of administration. For many women, menopause hormone therapy is an effective and safe option when it is prescribed on the basis of their medical history, their symptoms, and their risk factors.
Some situations call for a more thorough assessment, however, and some may represent a contraindication. That is precisely why a personalized approach is essential.
Why a personalized assessment matters
Before considering hormone therapy, it is important to review your symptoms, your medical history, your risk factors, your medications, your preferences, and your health goals.
This assessment helps determine whether hormone therapy belongs among the options to explore, or whether other approaches would suit your situation better.
- Your symptoms and how they affect your quality of life
- Your age and the stage of your menopausal transition
- Your relevant personal and family medical history
- Whether or not you still have a uterus
- Your cardiovascular, thromboembolic, and cancer-related risk factors
- Your preferences and your priorities
- The hormonal and non-hormonal options available to you
Systemic hormone therapy and local treatments
Systemic hormone therapy is generally used for symptoms that affect the whole body, such as hot flashes and night sweats. Transdermal 17β-estradiol, as a gel or patch, and micronized progesterone taken orally or vaginally are examples.
Local hormone treatments are safe and effective against the genitourinary symptoms that arise during the menopausal transition, known as genitourinary syndrome of menopause (GSM). Vaginal estrogen treatments, in the form of a vaginal ring, cream, or tablets, can be used for targeted intimate or urinary symptoms. Prasterone (dehydroepiandrosterone, or DHEA) as vaginal ovules and ospemifene as oral tablets may be further options to consider for relieving GSM.
What about “bioidentical” hormones?
The term “bioidentical” can be confusing. Despite the name, bioidentical hormones are usually synthesized from plants, but their molecular structure is identical to the hormones already present in the human body. Some prescribed, regulated hormones therefore do have a structure identical to what the body produces naturally. That does not mean every product marketed as “bioidentical” is equivalent.
Compounded preparations should not be presented as safer or more natural than regulated treatments. Their quality, their dosing, and their safety can vary. A conversation with a health professional helps distinguish the options overseen by Health Canada from non-standardized products.
Within menopause hormone therapy, the bioidentical hormones prescribed and regulated by Health Canada are 17β-estradiol and micronized progesterone. As of 2026, testosterone is not approved by Health Canada for use in menopausal women.
How Pause Claire can help
Pause Claire helps you understand your options so you can make informed decisions. The consultation is a chance to take stock of your symptoms, your health history, and your priorities, then to explore whether hormone therapy is among the appropriate options and to assess options requiring a prescription, where clinically indicated.
A decision that deserves clarity
Hormone therapy raises a lot of questions. Some women are afraid of it. Others wonder why the option was never clearly explained to them.
At Pause Claire, the goal is not to steer you toward a single option, but to give you clear, nuanced, evidence-based information so you can understand your choices and move forward with confidence.
References and suggested reading
- 1.Demers, Sylvie. (2026, May 28th). Prescrire l'hormonothérapie féminine avec Art et Science. [Hiver 2026]. Visioconférence donnée par Dre Sylvie Demers sur Zoom: Automne 2025/Hiver 2026. Gatineau, Canada.
- 2.Institut national d'excellence en santé et en services sociaux. (2024). Les bénéfices et les risques de l'hormonothérapie. https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Usage_optimal/Hormonotherapie/INESSS_Hormonotherapie_Benefices_risques_VF.pdf
- 3.Manson, J. E., Chlebowski, R. T., Stefanick, M. L., Aragaki, A. K., Rossouw, J. E., Prentice, R. L., Anderson, G., Howard, B. V., Johnson, K. C., Kooperberg, C., LaCroix, A. Z., Lewis, C. E., Liu, J., Martin, L. W., Ockene, J. K., O'Sullivan, M. J., Powell, L. H., Simon, M. S., Van Horn, L., … Wallace, R. B. (2013). The Women's Health Initiative hormone therapy trials: Update and overview of health outcomes during the intervention and post-stopping phases. JAMA, 310(13), 1353–1368. https://doi.org/10.1001/jama.2013.278040
- 4.North American Menopause Society. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028
- 5.Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Kooperberg, C., Stefanick, M. L., … Writing Group for the Women's Health Initiative Investigators. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial. JAMA, 288(3), 321–333. https://doi.org/10.1001/jama.288.3.321
- 6.Rowe, T. (2016). A word about bioidenticals. Journal of Obstetrics and Gynaecology Canada, 38(8), 697–699.
- 7.Women's Health Initiative Steering Committee. (2004). Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: The Women's Health Initiative randomized controlled trial. JAMA, 291(14), 1701–1712. https://doi.org/10.1001/jama.291.14.1701
Want to understand your options better?
A consultation can help clarify whether hormone therapy or other approaches might suit your situation.