“Needing” hormone replacement therapy (HRT) usually means your symptoms are significant enough that the potential benefits outweigh the risks, and there’s a clinical reason to treat (not just optimize numbers).
Below are the most common signs that it’s worth talking to a clinician about HRT, plus how providers typically confirm whether it’s appropriate.
Signs You Might Benefit From HRT During Menopause
HRT is most commonly considered when menopause symptoms are bothersome and disruptive, especially:
Hot Flashes And Night Sweats That Affect Daily Life
- Frequent hot flashes
- Night sweats waking you up
- Sleep disruption that leads to daytime fatigue/irritability
Systemic hormone therapy is considered the most effective treatment for vasomotor symptoms (hot flashes/night sweats).
Vaginal Or Urinary Symptoms That Don’t Improve With OTC Options
- Vaginal dryness, burning, pain with sex
- Recurrent UTIs or urinary urgency related to menopausal changes
For bothersome genitourinary symptoms not relieved with OTC options, local (vaginal) estrogen or other targeted therapies are often recommended (sometimes even when systemic HRT isn’t needed).
Menopause Symptoms Are Causing Secondary Problems
- Ongoing insomnia from night sweats
- Mood changes that seem tightly linked to the menopause transition (and not explained by another condition)
- Reduced quality of life and functioning
(Clinicians often still screen for anxiety/depression, thyroid issues, anemia, etc., because symptoms overlap.)
Signs Testosterone Replacement Might Be Considered (For Men)
For testosterone therapy, guidelines emphasize: symptoms + consistently low testosterone on blood tests.
Symptoms Consistent With Low Testosterone
Common examples include:
- Lower sex drive / fewer morning erections
- Erectile dysfunction (can have many causes)
- Unexplained anemia
- Reduced energy or stamina
- Loss of muscle mass/strength or increased body fat
- Low mood/irritability (nonspecific, but can be part of the picture)
Confirmed Low Testosterone On Repeat Morning Labs
The Endocrine Society recommends diagnosing hypogonadism only when there are symptoms/signs AND unequivocally and consistently low serum testosterone.
When HRT Is Often Overlooked
You might get told “it’s just stress” when it may be hormone-related if:
- Symptoms cluster around the menopause transition (especially hot flashes/night sweats + sleep disruption)
- You have new vaginal/urinary discomfort that doesn’t respond to typical OTC measures
- You have clear low-testosterone symptoms but haven’t had properly timed repeat labs
What Clinicians Usually Check Before Prescribing
For Menopause HRT
- Symptom pattern and severity
- Whether you still have a uterus (affects whether progesterone is needed)
- Personal/family history that changes risk (blood clots, stroke, certain cancers, etc.)
- Whether local vs systemic therapy is the better match
For Testosterone Therapy
- Repeat morning testosterone levels
- Possible causes (sleep apnea, obesity, medications, pituitary issues, etc.)
- Fertility plans (testosterone can suppress fertility)
- Contraindications and monitoring plan
A Key Point Many People Miss
HRT is generally not recommended solely to prevent chronic diseases (like heart disease) in otherwise asymptomatic postmenopausal people. The USPSTF recommends against using hormone therapy for the primary prevention of chronic conditions.
Quick Self-Check: When It’s Time To Ask About HRT
Consider bringing it up if:
- Symptoms are happening most weeks and affecting sleep, work, or relationships
- You’ve tried reasonable first-line non-hormonal steps (sleep hygiene, stress reduction, lubricants/moisturizers for dryness) and still feel stuck
- You suspect low testosterone and have persistent symptoms, especially sexual symptoms—and you’re willing to confirm with proper labs
If you are looking for hormone replacement in Roseville, CA, Xplore Health is the leading choice. Call now to learn more.
