An interactive, evidence-based tool to help you evaluate whether hormone replacement therapy is appropriate for your situation. Answer 7 questions, then receive a personalized summary you can bring to your doctor.
This tool does not replace medical advice. It organizes the evidence and your personal factors into a clear framework for an informed conversation with your healthcare provider.
Step 1 of 7
Where are you in the menopausal transition?
This determines the timing window, which is one of the most important factors in HRT risk/benefit analysis.
Select the option that best describes your current situation.
Early perimenopause — cycles changing but still relatively regular
Late perimenopause — skipping periods, significant symptoms
Post-menopause, within 10 years of last period (or under 60)
Post-menopause, more than 10 years since last period (or over 60)
Surgical menopause (ovaries removed)
Step 2 of 7
What symptoms are you experiencing?
Select all that apply. The severity and type of symptoms help determine how strongly HRT may benefit you.
Hot flashes / night sweats
Sleep disruption
Mood changes / anxiety / depression
Brain fog / cognitive difficulties
Vaginal dryness / urogenital symptoms
Joint pain / stiffness
Bone density loss (osteopenia / osteoporosis)
Low libido
No significant symptoms currently
Mild — noticeable but manageable
Moderate — affecting daily life or sleep
Severe — significantly impairing quality of life
Step 3 of 7
Cardiovascular risk factors
These factors influence the cardiovascular risk/benefit profile of HRT — especially estrogen formulation choice.
Hypertension (high blood pressure)
High cholesterol / elevated ApoB
Type 2 diabetes or prediabetes
Current smoker
BMI over 30
Family history of early heart disease (before 55 in male / 65 in female relative)
None of the above
Step 4 of 7
Cancer history & risk factors
Personal and family cancer history is a key factor in HRT decision-making — particularly for breast cancer.
No personal history of cancer
Personal history of breast cancer
Personal history of endometrial cancer
Personal history of other cancer (not breast/endometrial)
No family history
Distant relative (aunt, grandmother)
First-degree relative (mother, sister)
Known BRCA1/BRCA2 mutation carrier
Step 5 of 7
Blood clotting risk factors
Venous thromboembolism (VTE) risk is a key differentiator between oral and transdermal HRT formulations.
Personal history of DVT or pulmonary embolism
Known clotting disorder (Factor V Leiden, etc.)
Family history of blood clots
Prolonged immobility / recent major surgery
None of the above
Step 6 of 7
Uterine status
Whether you have a uterus determines whether progesterone must be combined with estrogen (to protect the endometrium).
Yes — uterus intact
No — prior hysterectomy
Step 7 of 7
Your priorities
What outcomes matter most to you? This helps frame the conversation with your provider.
Relief from vasomotor symptoms (hot flashes, sweats)
Bone density preservation
Cardiovascular protection
Cognitive health / neuroprotection
Sleep quality improvement
Sexual health / vaginal comfort
Overall longevity / biological age reduction
Your Personalized Summary
HRT Decision Framework Results
Based on your answers, here is an evidence-based summary of the considerations, formulation guidance, and discussion points for your healthcare provider.
Important: This tool provides educational information only. It is not a medical recommendation or diagnosis. HRT decisions should be made in partnership with a qualified healthcare provider who can evaluate your complete medical history, perform physical examinations, and order appropriate laboratory testing. The information presented here is based on current evidence-based guidelines from the North American Menopause Society (NAMS), the Endocrine Society, and peer-reviewed literature.