Some people may decide to stop taking hormone therapy for menopause symptoms because they no longer need it or they’re concerned about health risks. Stopping hormone therapy may cause symptoms to return.

Hormone therapy is one of the more effective treatments for menopause symptoms. It’s not right for everyone, but for many people, it can be a safe and long-term treatment.

If you want to stop taking hormone therapy, talk with your doctor. They can help you figure out how quickly to stop and what you might expect after discontinuation.

People might decide to stop taking menopausal hormone therapy for a few reasons.

Some people may simply no longer need it. Menopause symptoms may peak in intensity during perimenopause, when hormone levels fluctuate significantly. Once postmenopause begins after a period of 12 consecutive months with no menstrual cycles, hormone levels continue to decline and eventually become steadier.

Though menopause symptoms can continue into postmenopause — sometimes for decades — they may be less severe and you may not need hormone therapy to manage them.

For other people, the potential health risks may outweigh the benefits of hormone therapy after a certain amount of time.

Possible health risks

The use of hormone therapy may increase certain health risks for some people, including those who are older than 60 years or have a history of certain conditions.

For example, in people older than 60, the risk of breast cancer may slightly increase with long-term use of oral combined hormone therapy (therapy that includes both estrogen and progesterone).

Additionally, hormone therapy may not be a good option for people with a history of conditions such as ischemic stroke or venous thromboembolism (a blood clot in a vein). If you experience one of these health events while taking hormone therapy, your doctor may recommend that you discontinue it.

People who stop menopausal hormone therapy may experience a recurrence of symptoms, including hot flashes, night sweats, and mood changes.

An older study suggests that people may experience a recurrence of symptoms within a year of stopping hormone therapy. After 3 years, many of the participants were no longer experiencing symptoms.

Though symptoms can occur soon after stopping, they may decrease in intensity and frequency thereafter. If your symptoms continue and are still disruptive, your doctor may recommend other treatment options.

There are currently no clinical guidelines around the best way to discontinue menopausal hormone therapy. But it may be better to stop gradually rather than all at once.

The doctor is in

Menopause Society Certified Practitioner Stacy Henigsman, DO, has this to say about stopping menopausal hormone therapy (MHT):

“Several strategies might help make the transition off MHT smoother. Many doctors recommend gradually tapering the dose rather than stopping abruptly, as this may help reduce the intensity of returning symptoms.

“If symptoms do reappear, alternative treatments such as low dose vaginal estrogen or other nonhormonal therapies can offer relief. For hot flashes and night sweats, certain antidepressants (SSRIs or SNRIs) may be effective.”

This is an excerpt from Unpaused, Healthline and Optum Now’s free newsletter dedicated to helping people navigate menopause.

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The safety of long-term hormone therapy is still being studied. For people without health risks, long-term hormone therapy may help manage persistent symptoms and lower the risk of osteoporosis.

Ultimately, you and your doctor should work together to determine how long you should take hormone therapy.

Hormone therapy can be an effective way to manage menopause symptoms, but someone may want to stop for a few reasons. They may no longer need it, or they may be concerned about certain health risks, such as a potential increased risk of breast cancer.

Though there aren’t any guidelines around how quickly to stop hormone therapy, tapering off may help reduce the intensity of returning symptoms.

The safety of long-term hormone therapy can vary depending on your specific health situation. You and your doctor can work together to decide on the best treatment plan for you.