What are the pros and cons of different types hormone therapy?

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10th March 2025BLOG
Beth Messenger Outside Square
Dr Beth Messenger
Beth is former medical director at Sexual Wellbeing Aotearoa and a strong advocate for menopause treatment.

Hormone therapy is the most effective treatment for many menopause symptoms

Hormone therapy works by replacing the oestrogen – and sometimes progesterone – your body is no longer producing. Some of the symptoms that respond well to hormone therapy are: hot flushes, night sweats, and mental health symptoms.

There are a few different ways to take hormone therapy. Treatment can be: 

  • oral hormone therapy (taking pills) 
  • transdermal (through the skin, such as oestrogen gels and patches)
  • intrauterine (an intrauterine device, IUD, with hormones which is inserted into your uterus)
  • vaginal (oestrogen treatments that can be applied inside the vagina to help with symptoms like dryness, irritation, and pain during sex)

Learn more about hormone therapy

Different modes of hormone therapy

All these therapies have the potential to reduce your symptoms, and they all have their own drawbacks. Below we've listed some of the commons pros and cons of different types of hormone therapy. When you attend a Menopause Wellbeing appointment, we’ll discuss your options and decide together what’s right for you. 

Method Pros Cons
Oral
  • Consistently and easily available 
  • Convenient and easy to take
  • Small increased risk of blood clots  
  • Risk of gall stones 
  • Some side effects might include headaches, nausea, and lower libido
Oestrogen patches
  • Easy to use 
  • Reduced risk of blood clots compared to tablets 
  • Steady dose delivery 
  • Safe for people with focal migraines and liver issues. 
  • There is a shortage of oestrogen patches in Aotearoa, so access to this medication can be inconsistent 
  • Can leave sticky residue on your skin 
  • Might not adhere well in hot climates or if you sweat a lot 
  • Can cause irritation for some people 
  • Some people have trouble remembering to change twice weekly 
  • Oestrogen-only, so you’ll need a second medication if progesterone needed 
Gels
  • Discrete and absorbs easily 
  • Reduced risk of blood clots compared to tablets 
  • It’s easy to alter your dosage, which is useful when your symptoms are fluctuating during perimenopause 
  • Strong alcohol smell 
  • Takes a few minutes to dry 
  • Need to avoid showering for an hour and skin contact with other people (especially males) 
  • Oestrogen-only, so if you need to take progesterone as well, you’ll need to take a second medication. 
Hormonal Intrauterine device (Mirena) 
  • Lasts five years for progesterone component of hormone therapy 
  • Provides contraception 
  • Provides bleeding control and helps pain 
  • Means you don’t have to take a progesterone tablet every day 
  • Inserted into your uterus, which involves some potential risks and a procedure which can be painful 
  • Irregular bleeding for the first 6-12 months (for some people) 
  • Can result in skin, acne, and mood changes, particularly in the first 6-12 months for some people 
Vaginal oestrogen treatments
  • Helps with some vaginal/vulval symptoms that hormone therapy may inadequately help 
  • Helps with bladder symptoms 
  • Can help with painful sex and therefore libido
  • Can be a bit messy
  • Can cause irritation for some people
  • Can sometimes cause bleeding
MW Feature Image 1 Paula-Temaari
Let us help you manage your menopause symptoms

Book your 45-minute initial appointment with one of our menopause clinicians. We'll come up with a tailored treatment plan which could include hormone therapy.

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