Hot flashes, low energy, mood changes, or stubborn weight gain? You’re not alone. The latest HRT statistics show just how many women in menopause or perimenopause seek treatment for the same symptoms.
Here, we’re breaking down the latest data on hormone replacement therapy, including prescription trends, effectiveness, cost, access, and long-term health.
At Spartan Medical Associates, we offer bioidentical hormone replacement therapy, using your symptoms, lab results, medical history, and goals to determine whether BHRT could be the right fit for you.
Ready to take back your energy? Book a free consultation to find out whether BHRT could be right for you.
HRT Use and Prescription Trends
Has the use of estrogen-based hormone replacement therapy increased since 2018?
Yes. Prescriptions for estrogen-based hormone replacement therapy more than doubled from 2018 to 2026.
Have hormone replacement therapy prescriptions for women increased since 2021?
Hormone replacement therapy prescriptions for women increased by 72% from 2021 to 2025.
What percentage of eligible women use menopausal hormone therapy?
Only 7.2% of eligible women reportedly use any form of prescription menopausal hormone therapy.
What percentage of women seek treatment for menopause symptoms?
About 40% to 60% of women seek treatment for menopause symptoms, while roughly 20% may wait more than a year before seeking care.
Has estrogen-based HRT use increased among women ages 45 to 54?
Estrogen-based HRT use among women ages 45 to 54 increased by 184.2% from 2018 to February 2026.
Which age groups are most commonly prescribed estrogen-based HRT?
In one study, estrogen-based HRT prescribing increased across every age group, with the highest rates seen among women ages 45 to 54 by February 2026:
- Ages 45–54: 49.0 per 1,000 women
- Ages 55–64: 41.6 per 1,000 women
- Ages 65–74: 22.1 per 1,000 women
- Ages 75 and older: 15.1 per 1,000 women
- Ages 18–44: 7.2 per 1,000 women
Are older women more likely to use HRT than younger women?
Yes. Among women receiving menopause treatment, 76.3% of those ages 57 to 64 had an HRT prescription, compared with 56.1% of women ages 45 to 56.
HRT Use by Race and Ethnicity
How do HRT prescription rates vary by race and ethnicity in the United States?
As of 1999, HRT prescription rates varied significantly by demographic group, with White women reporting the highest rates:
- White women: 33%
- African American women: 25%
- Latina women: 23%
- Asian women: 21%
- Soviet immigrant women: 6.6%
Are Black women less likely to be prescribed hormone replacement therapy?
Black women are 26% less likely to be prescribed HRT than women of other races.
Types of Hormone Replacement Therapy
What is the most common form of estrogen-based HRT?
Estrogen patches became the most common form of estrogen-based HRT by February 2026, with use increasing from 6.2 to 19.9 prescriptions per 1,000 women since 2018.
Has use of vaginal estrogen creams increased since 2018?
One study found that the use of vaginal estrogen creams rose from 2.8 to 14.3 per 1,000 women from 2018 to 2026, a 413.3% increase over the study period.
How many women in the United States use compounded bioidentical hormones?
An estimated 1 million to 2.5 million U.S. women use compounded bioidentical hormones.
How much revenue do compounded menopause prescriptions generate each year?
Annual sales of an estimated 26 million to 33 million units of compounded menopause prescriptions generate more than $1 billion in revenue each year.
HRT Effectiveness for Menopause Symptoms
How many women find relief from menopause symptoms within two months of starting HRT?
About 90% of women reportedly experience symptom relief within two months of starting properly managed hormone replacement therapy.
How effective is HRT for reducing hot flashes?
Hormone replacement therapy can reduce hot flash frequency by about 75% and hot flash severity by about 87%.
How many women find that HRT improves sleep disturbances?
Sleep disturbances reportedly improve in about 85% of women using hormone replacement therapy.
Can HRT improve quality of life scores?
Yes, hormone therapy has been associated with a 45% improvement in quality-of-life scores.
How often do menopause symptoms return after stopping HRT?
About 50% of women may experience a return of vasomotor symptoms, such as hot flashes and night sweats, after discontinuing HRT.
HRT and Long-Term Health Benefits
Can hormone therapy reduce the risk of bone fractures?
Hormone therapy has been associated with about a 35% reduction in bone fracture risk.
Can estrogen-only HRT reduce health risks in women over age 65?
Yes. In women older than 65, estrogen-only HRT has been associated with a 19% reduction in mortality, along with lower risks of breast, lung, and colorectal cancer.
Vaginal Estrogen and Special Health Considerations
What percentage of breast cancer survivors can safely use vaginal estrogen?
About 70% of breast cancer survivors can reportedly use vaginal estrogen safely, depending on their individual history and treatment plan.
How effective is vaginal estrogen for preventing recurrent UTIs?
Vaginal estrogen has been associated with a 45% to 60% reduction in recurrent urinary tract infections.
HRT Insurance Coverage and Costs
What percentage of insurance plans cover estradiol?
About 90% of insurance plans reportedly cover estradiol, although high copays and limited coverage for compounded hormone preparations can still create barriers to treatment.
What percentage of women face insurance or copay barriers for HRT?
About 60% of women face copays for HRT, while 8% report having no insurance coverage for treatment.
How many women delay or stop HRT because of cost?
About 21% of women prescribed HRT have delayed or avoided HRT because of cost, while 10% have stopped their medications due to expense.
Do brand-name estrogen medications cost more than generic estradiol?
Yes. Generic estradiol tablets may cost about $10 to $30 per month, compared with roughly $200 to $400 per month for brand-name Premarin.
Book A Consultation To Find Out If BHRT Could Be Right For You
You don’t have to keep brushing off low energy, mood changes, weight gain, or other menopause symptoms.
At Spartan Medical Associates, we use your symptoms, lab results, medical history, and goals to determine whether BHRT could be the right option for you, adjusting your care based on your body’s response over time.
Book a free consultation to find out if BHRT could be right for you.
Sources
Truveta. “Estrogen-based hormone replacement therapy use is rising.” April 9, 2026. https://www.truveta.com/blog/research/estrogen-based-hormone-replacement-therapy/
Kersten Bartelt, RN. “Hormone Replacement Therapy Prescriptions for Women Up 72% Since 2021.” November 24 2025. Epic Research. https://www.epicresearch.org/articles/hormone-replacement-therapy-prescriptions-for-women-up-72-since-2021/
Sarah Daccarett, MD. “36 Hormone Replacement Therapy (HRT) Statistics – Essential Facts Every Woman Should Know in 2026.” January 3, 2026. Inner Balance. https://www.innerbalance.com/p/learn/hormone-replacement-therapy-hrt-statistics-essential-facts-every-woman-should-know
Arleen F. Brown. “Ethnic Differences in Hormone Replacement Prescribing Patterns.” November 14, 1999. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC1496759/
Beth Carter. “Women in Menopause Often Go Untreated.” April 17, 2025. AARP. https://www.aarp.org/pri/topics/health/conditions-treatment/menopause-women-untreated/