How can I assess whether a patient is a suitable candidate for Hormone Replacement Therapy (HRT)?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

To assess whether a patient is a suitable candidate for hormone replacement therapy (HRT), first evaluate the presence of menopausal symptoms such as vasomotor or genitourinary symptoms, and consider if lifestyle measures or non-hormonal treatments have been ineffective .

Assess the patient's medical history, including any contraindications such as personal or family history of breast cancer, thromboembolic disease, or other significant health risks .

Review the patient's co-morbidities, such as cardiovascular disease, diabetes, or hypothyroidism, and manage these risk factors appropriately before considering HRT .

Discuss the potential benefits and risks of HRT with the patient, including the importance of individual choice, and consider offering the lowest effective dose for the shortest duration necessary .

Evaluate the patient's age and specific circumstances, such as premature ovarian insufficiency or early menopause, and tailor the assessment accordingly .

If there is uncertainty about safety or appropriateness, liaise with relevant specialists or seek advice from a healthcare professional with expertise in menopause .

Educational content only. Always verify information and use clinical judgement.