Navigating the Decision to Stop HRT: What We Know — and What We Still Don’t
At Sirona Health, we support women in making informed, confident choices about their health — especially during menopause. For many, hormone replacement therapy (HRT) can be transformative, easing symptoms like hot flushes, night sweats, and brain fog. But as the number of women starting HRT rises, more are also wondering: when, why, and how should I stop?
The answer is: it depends — and we need more research.
Why Are More Women Using HRT?
In recent years, media awareness and menopause advocacy have driven a welcome surge in HRT use. NHS data shows a 12% increase in prescriptions in just one year, with 2.6 million women in England now identified as HRT users. Yet, only 9% of respondents to the government’s Women’s Health Strategy felt they had enough information about menopause and its treatment.
This mismatch highlights a key issue: while HRT uptake is growing, guidance around stopping HRT remains unclear.
When Should You Stop HRT?
There’s no one-size-fits-all timeline. NICE guidelines recommend reviewing the need for HRT regularly, but they don’t specify an “end date.” The right time to stop depends on many factors, including:
Your age and stage of menopause
The severity of your symptoms
Personal or family risk of osteoporosis, breast cancer, cardiovascular disease
Your quality of life
The key takeaway: stopping HRT should be a collaborative, individualised decision between you and your healthcare professional.
If you would like to understand more about your risk of osteoporosis then please read my blog A Women's Health Doctor's Guide to Preventing Osteoporosis.
Why Do Women Stop HRT?
Some women choose to stop because their symptoms have improved, or they’re concerned about long-term risks such as breast cancer. Others experience side effects or receive advice to stop after certain health diagnoses. Unfortunately, some stop abruptly after hearing conflicting or alarming media reports — sometimes without medical advice.
But stopping isn’t always easy.
What Happens When You Stop?
Up to 40% of women experience a resurgence of symptoms, especially vasomotor ones like hot flushes and night sweats. Even those who didn’t have these symptoms initially can develop them after stopping. Understandably, over a quarter of women who stop HRT go on to restart it, often entering a frustrating cycle of symptoms and uncertainty.
Restarting at an older age, however, may come with increased risks of stroke, dementia, and cardiovascular disease. That’s why it’s so important to get the timing — and the method — right.
Should You Taper or Stop Suddenly?
Many clinicians recommend tapering HRT gradually to reduce symptom rebound, but the evidence is surprisingly weak. Existing studies are small, inconsistent, and mostly based on oral HRT — not the increasingly common transdermal preparations, which are often easier to adjust.
More research is urgently needed to guide both clinicians and women on the safest, most effective ways to discontinue HRT. Until then, the approach should be personalised, discussed in advance, and supported with regular follow-up.
What This Means for You
If you’re considering stopping HRT — or simply wondering what to expect in the future — know that there’s no “right” time or method for everyone. At Sirona Health, we’re here to help you weigh the pros and cons, prepare for what’s next, and support your health through the menopause transition and beyond.
If you’d like to talk more about starting, continuing, or stopping HRT, book a consultation with Dr Standen at www.sironahealth.co.uk/appointments.