“Is HRT Safe in 2025? What the FDA’s New Panel Revealed About Breast Cancer, Alzheimer’s and Your Hormones”
If you've ever been scared off HRT by warnings from 20 years ago, it might be time to have another chat with your GP or menopause specialist:
For decades, hormone replacement therapy (HRT) has been shrouded in fear and misinformation. Many women were told it was dangerous - that it would increase their risk of breast cancer, heart disease, even dementia.
But in July 2025, something powerful happened.
The FDA gathered a group of leading scientists, doctors and menopause experts to reassess those warnings. And their message was clear: today's HRT isn't the same as it was 20 years ago - and neither is what we know about it.
And we know that in women with obesity, there is an increased risk of cardiovascular disease, high blood pressure, pre-diabetes, raised blood lipids, fatty liver disease, chronic kidney disease and several cancers including breast, endometrial and colon cancer, as well as osteoarthritis of the bones and gall bladder disease (British Menopause Society 20205).
So, even if you've lost weight with a GLP-1 and are experiencing menopausal symptoms, have bypassed HRT because of what you understood to be potential risks, this may be of interest to you and your health.
"Your hormones weren’t just reproductive - they were metabolic protectors throughout your body. And rebalancing them can be a vital step in rebuilding trust with your body."
If you are already on HRT as well as a GLP-1, please note that the British Menopause Society has made recommendations about how you take your oestrogen and progesterone (if uterus intact) because of the potential impact of delayed gastric emptying and gastro-intestinal side-effects:
- all oestrogen to be taken transdermally (through the skin) rather than orally (tablet) (eg. patch, gel, spray)
- progesterone / progestogen - consider a non-oral route such as the Mirena coil for uterine protection. (I have also maintained my oral dose of progesterone because it helps me sleep). If oral dosing is preferred, it is rerecommended that your dose of progesterone is increased each time you up your GLP-1 dose, for the following 4 weeks (and when you start - but it may be too late for that!).
Ok.. Back to the outcomes of the expert panel. Yes, the panel was based in the US - but the evidence they shared is relevant here in the UK, too. Most women are prescribed body-identical oestrogen and micronised progesterone, just like those discussed below.
5 things the FDA panel wants the women of the world to know about HRT
1. Modern HRT doesn’t increase breast cancer risk
The early concerns came from outdated forms of HRT specifically, conjugated equine oestrogen - (from pregnant horses urine!) and synthetic progestin).
But these aren’t what most women are prescribed today. The FDA panel made it clear that:
- Body-identical HRT (like transdermal oestradiol and micronised progesterone) wasn’t part of those early studies
- In the oestrogen-only arm of the Women's Health Initiative (WHI) - a major long-term observational study, involving over 160,000 post-menopausal women in the US - breast cancer risk was actually reduced
2. HRT may protect your brain
Dr Roberta Diaz Brinton and others presented compelling data on how early HRT can support brain health, especially if started within 10 years of menopause.
It may:
- Reduce the risk of Alzheimer’s
- Preserve brain structure and blood flow
- Reduce neuroinflammation
3. It supports your heart
When started in the right window (typically before age 60), HRT can:
- Improve cholesterol levels
- Keep arteries flexible
- Lower the risk of coronary heart disease by up to 50%
4. It protects your muscle and metabolism
Hormones aren’t just about fertility. They play a huge role in:
- Muscle mass maintenance
- Fat distribution and insulin sensitivity
- Supporting steady energy and healthy glucose control
5. It protects your bones
HRT remains the gold standard for protecting against osteoporosis. It helps:
- Prevent bone loss
- Reduce fracture risk
- Improve long-term strength and mobility
What If You Have a History of Breast Cancer?
If you have a personal or strong family history of breast cancer, it’s essential to work closely with a menopause-informed specialist.
There are often still safe options available, but they must be individualised.
The Bottom Line
Modern HRT is not the villain it was once made out to be.
In fact, used appropriately, it can be one of the most powerful tools to support:
- Cognitive health
- Metabolic resilience
- Bone density
- Muscle preservation
- Emotional wellbeing
"Your hormones weren’t just reproductive - they were metabolic protectors throughout your body. And rebalancing them can be a vital step in rebuilding trust with your body."
Wondering why I'm sharing this?
Because I believe women deserve access to evidence that supports their goals - not fear-based narratives or outdated warnings.
Last week's expert panel on menopause and hormone replacement therapy brought together leading names in women's health. These are clinicians and researchers at the cutting edge, working to make healthcare more equitable and more accurate.
But I know how confusing and scary it can feel.
And I know how hard it can be to access a GP who really understands the data.
In women with obesity, there is an increased risk of endometrial hyperplasia
So if this blog starts to gave you clarity, reassurance, or even just a sense of "Ohhh, that explains it" then it was worth sharing.
The full link is her for you to watch on YouTube. Each presentation is only 5 minutes long and in -non-technical language for ease of understanding.
[This blog is for informational purposes only and does not replace medical advice.]
Inspired by the 2025 FDA Expert Panel on HRT, including Dr. Heather Hirsch, Dr. Barbara Levy, Dr Joann Pinkerton , Dr. James
Simon, Dr. Philip Sarrel, Dr. Roberta Diaz Brinston, Dr Vonda Wright, Dr Kelly Casperson, Dr Mary Jane Minikin, Dr Rachel Rubin and Dr Howard Hodis.
The link to the British Menopause Society advice for women on GLP-1 and HRT
