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What Is Hormone Replacement Therapy (HRT), and What Are the Benefits?

What Is Hormone Replacement Therapy (HRT), and What Are the Benefits?

What Is Hormone Replacement Therapy (HRT), and What Are the Benefits?

Hormone replacement therapy (HRT) is the medical use of estrogen, progesterone or testosterone to bring hormone levels back up when they’ve dropped below normal — most often because of menopause in women, or age-related or medical testosterone deficiency in men. Its proven benefits include relief from menopausal hot flashes and night sweats, stronger bones, and, in men with confirmed low testosterone, better body composition, sexual function and energy.

Are Patients Satisfied With HRT?

Yes — for both women and men, and the data is consistent. In a survey of women at a specialist menopause clinic, published in Climacteric, 89% of women on hormone therapy said they were satisfied with how it addressed their symptoms. In a 2024 survey of men on testosterone therapy, published in the International Journal of Impotence Research, men using subcutaneous pellets reported 90.0% satisfaction — the highest figure of any delivery method studied.

That pattern of high satisfaction once patients actually start shows up again and again in the research. The bigger obstacle tends to be getting to a proper evaluation in the first place, not the treatment itself once it begins.

What Hormones Does HRT Replace?

HRT most often replaces three hormones: estrogen, progesterone and testosterone. Estrogen treats hot flashes and the vaginal and urinary symptoms of menopause, and protects bone. Progesterone is added for any woman who still has a uterus, because estrogen alone raises the risk of uterine cancer. Testosterone is used in men with confirmed low levels, and off-label in women in specific situations.

What Are the Benefits?

The benefits are best understood by what they’re treating:

Benefit

Who It’s For

Relief from hot flashes and night sweats

Women with these symptoms — the best-supported use, and the main reason HRT exists.

Stronger bones

Postmenopausal women; 33% fewer hip fractures in one major trial.

Relief from vaginal and urinary symptoms

Postmenopausal women; responds well, including to local (vaginal) treatment alone.

Better body composition

Men with confirmed low testosterone; about 1.6 kg less fat and 1.6 kg more muscle on average.

Sexual function and libido

Men with low testosterone, and postmenopausal women with low desire.

Energy, mood and sleep

Commonly reported by both, and often meaningful.

 

Good News: The FDA Has Updated Its Hormone Therapy Labeling

For more than twenty years, menopausal hormone therapy carried the FDA’s most prominent form of warning label. That language dated to 2003 and rested on a single large study of women who were, on average, 63 years old, using a hormone formulation that is rarely prescribed today. Clinicians argued for years that it did not reflect the experience of the women who actually take HRT now — typically women in their late forties and fifties, using different formulations, starting near the onset of menopause.

The FDA agreed. After a comprehensive review of the evidence, the agency announced in November 2025 that it was removing the broad warning, and in February 2026 it approved the first updated labels. FDA Commissioner Marty Makary summed up the shift plainly: “Women and their physicians should make decisions based on data, not fear.” The agency also pointed to randomized data showing lower all-cause mortality and fewer fractures among women who begin therapy within ten years of menopause onset. For a treatment that had spent two decades under an outdated cloud, that is a meaningful, evidence-based shift — and it is the context worth knowing before you weigh hormone therapy for yourself.

How Is a Hormone Deficiency Diagnosed?

For men, the guideline is specific: a fasting, early-morning blood draw measuring total testosterone, confirmed with a second test. The American Urological Association uses a threshold of 300 ng/dL; the Endocrine Society suggests 264 ng/dL.

For women, diagnosis is mostly clinical. Hormone levels swing too widely during perimenopause for a single blood draw to mean much, so your symptom pattern and menstrual history carry more weight than a single number — a real consultation, not a lab panel ordered online.

What Should You Know Before Starting?

Suitability depends on your personal and family health history, which is reviewed at your consultation. For women, that generally means a personal history of breast or endometrial cancer, unexplained vaginal bleeding, active liver disease, or a history of blood clots or stroke. For men, it means reviewing prostate health and blood count before and during treatment. For the large majority of patients who don’t carry one of these histories, none of it stands in the way — it simply shapes which formulation and route Dr. Temkin recommends.

How Long Do People Stay on Hormone Therapy?

There’s no fixed stopping date. Current guidance favors periodic reassessment over arbitrary time limits: treatment continues as long as it’s still treating the original problem, the benefits still outweigh the risks for you specifically, and your monitoring stays current.

About Dr. Michael Temkin, DO

Dr. Michael Temkin, DO is an internal medicine physician who has been in private practice in San Ramon for 25 years, and he manages hormone therapy for both men and women as a Certified BioTE Provider. He evaluates hormone concerns as part of a full internal medicine workup — thyroid function, metabolic markers, cholesterol and blood count are reviewed alongside sex hormones, because symptoms like fatigue and weight gain can have several causes, not just one.

Hormone therapy is available in the San Ramon office, fully remotely, or as a hybrid, with pellet therapy offered where it fits. Because Temkin Health is a concierge practice, appointments are unhurried and you can reach him directly with questions between visits. Where hormone concerns overlap with weight, the optional hormone assessment inside LeanMD is the bridge between the two — hormones are rarely the whole story, and Dr. Temkin looks at the full picture rather than one number in isolation.

Frequently Asked Questions

What is hormone replacement therapy used for?

It treats symptoms of hormone deficiency. In women, that mainly means hot flashes, night sweats, sleep disruption, vaginal and urinary symptoms, and preventing bone loss after menopause. In men, it means treating confirmed low testosterone causing symptoms like low libido, fatigue, muscle loss and increased body fat.

Is HRT safe?

The evidence now supports it for most women. In November 2025 the FDA began removing the broad warnings that had shaped HRT decisions since 2003, citing outdated risk data from a study of much older women using a formulation rarely prescribed today, and in February 2026 it approved the first updated labels. Current guidance finds a favorable balance for women under 60 or within 10 years of menopause onset. In men, TRT’s largest safety trial (TRAVERSE) found no increase in major heart events. Individual suitability still depends on your health history and is confirmed at a medical consultation.

What are the benefits of hormone replacement therapy?

The best-supported benefits are relief from hot flashes and stronger bones in women, and better body composition, libido and energy in men with confirmed low testosterone. One major trial found hormone therapy cut hip fracture risk by 33%. In men, testosterone treatment is linked to about 1.6 kg less fat and 1.6 kg more muscle on average.

Are patients satisfied with HRT?

Yes. In a survey of women at a specialist menopause clinic, 89% of women on hormone therapy said they were satisfied with how it addressed their symptoms. In a 2024 survey of men on testosterone therapy, men using pellets reported 90% satisfaction, the highest of any delivery method.

At what age should you start hormone therapy?

For women, the evidence favors starting within 10 years of menopause onset or before age 60, when the benefit-risk balance is best. For men, there’s no age cutoff — treatment depends on confirmed low testosterone plus symptoms, not age alone.

Talk to Dr. Temkin About Hormone Therapy

Whether hormone therapy is right for you is a question answered with lab work, your medical history, and a real conversation about what you’re experiencing. Call Temkin Health at (925) 866-3900 or request a consultation online.

About Temkin Health

Temkin Health is a concierge internal medicine practice at 1081 Market Place, Suite 300, San Ramon, CA 94583, led by Dr. Michael Temkin, DO, who has been in private practice in San Ramon for 25 years. The practice offers concierge primary care, the LeanMD medical weight loss program, bioidentical hormone replacement therapy for men and women, and longevity medicine. Dr. Temkin is a Certified BioTE Provider. Phone: (925) 866-3900.

Related Reading

Each of the above is part of Temkin Health’s San Ramon hormone therapy resource library.

Sources

Disclaimer

This article provides general health information and is not medical advice for any specific situation. Reading it does not create a doctor-patient relationship. Hormone therapy is a prescription treatment with risks as well as benefits, and suitability is determined at a medical consultation with a licensed clinician. Results vary between individuals; every figure cited describes findings in studied populations rather than a predicted individual outcome. Compounded preparations, including compounded pellets, are not FDA-approved, which means the FDA does not evaluate them for safety, effectiveness or quality. Consult a licensed healthcare provider to discuss all treatment options, including potential risks and benefits.

Last updated September 2026.

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