Menopausal hormone therapy (MHT) in Australia: a clear guide

Written by Sharryn Ludlow, founder of Menopause Resource Hub. Checked against current Australian guidance from the Australasian Menopause Society, the RACGP, Jean Hailes for Women’s Health and the Therapeutic Goods Administration. Last updated 26 June 2026. [Read our editorial policy]

Menopausal hormone therapy (MHT), still widely known as hormone replacement therapy (HRT), is a prescription treatment used in Australia to manage menopause symptoms caused by declining oestrogen. It is the most effective evidence-based treatment for moderate to severe symptoms such as hot flushes, night sweats, sleep disruption and mood changes, and current Australian guidance, including from the RACGP, supports it as a first-line option for menopausal symptoms in women for whom it is suitable.

This guide explains what MHT is, the types available in Australia, the benefits and the risks, what it costs, and how to find a doctor to prescribe and review it. If you are weighing up whether to start, our broader guide to menopause treatment in Australia sets MHT alongside the non-hormonal and lifestyle options, and women looking for non-hormonal approaches can read our guide to natural menopause treatment.

What Is MHT (and why is it also called HRT)?

MHT and HRT are two names for the same treatment. In simple terms, it supplements the hormones, primarily oestrogen, and often progesterone, that the body produces less of during perimenopause and menopause. This helps steady the hormonal fluctuations that drive many menopause symptoms.

In Australia, “MHT” is now the preferred medical term, because it describes managing hormonal change rather than fully replacing hormones. “HRT” is still the term most women know and use. Both refer to the same thing. For some women, testosterone is also part of the picture, which we cover in the broader treatment guide.

How MHT works in the body?

During perimenopause and menopause, the ovaries gradually produce less oestrogen. That shift affects many systems, including temperature regulation, sleep, mood and cognition, which is why symptoms can feel so wide-ranging.

MHT works by restoring more stable hormone levels, which can:

• Reduce hot flushes and night sweats
• Improve sleep quality
• Support mood and emotional steadiness
• Relieve vaginal dryness and urinary symptoms
• Help protect bone density

Modern MHT does not aim to return hormones to pre-menopause levels. It uses the lowest effective dose to relieve symptoms while keeping safety front of mind.

What types of MHT are available in Australia?

One advantage of MHT is that it can be tailored to your symptoms, lifestyle and medical history. The form matters as much as the hormone.

• Patches (transdermal). Applied to the skin and changed once or twice a week, patches give a steady release of oestrogen. Because they bypass the liver, they are often preferred where clotting risk is a consideration.
• Gels and sprays (transdermal). Applied to the skin daily, usually on the arms or thighs, with flexible dosing that can be adjusted as symptoms change.
• Tablets (oral). Taken once a day, and often combining oestrogen with a progestogen. The simplest routine for some women.
• Vaginal oestrogen (cream, pessary or ring). Acts locally in the vaginal and urinary tissues, and is particularly effective for dryness, discomfort during sex and urinary symptoms. Very little is absorbed into the bloodstream, so it is considered safe for most women, including many who cannot use other forms.

A menopause-informed doctor can help you match the form, dose and combination to your needs.

Is there an MHT patch shortage in Australia?

Yes. Australia has had recurring shortages of oestradiol (oestrogen) patches for several years, driven by manufacturing issues and rising global demand, and the Therapeutic Goods Administration has confirmed shortages of several brands and strengths continuing through 2026. This is worth knowing if you use patches or are thinking about starting them, and it is a practical question the official pages can be slow to answer plainly.

A few things that help:

• Your pharmacist can usually substitute a different brand or strength of patch without a new prescription, where it is clinically appropriate, under a temporary TGA instrument. You do not always need to see your GP again first.
• Alternatives exist. Oestrogen gels and tablets suit many women, although gels are not always subsidised and can cost more. A menopause-informed clinician can convert your usual patch dose to another form.
• Do not cut patches in half to make them last. The TGA advises this makes the dose unreliable.
• If you are starting MHT for the first time, your doctor may talk through which form is most reliably available right now.

For the current status of specific brands, the TGA medicine shortages page is the live source. If your usual patch is unavailable, speak with your pharmacist or GP rather than going without.

What are the benefits of MHT?

MHT is widely recognised as the most effective treatment for moderate to severe menopause symptoms. According to the Australasian Menopause Society, around 80 percent of women experience menopause symptoms, and roughly one in five experience symptoms severe enough to significantly affect daily life. Despite this, MHT remains underused, often because of outdated fears based on early research that has since been re-evaluated.

For many women, MHT can bring meaningful improvement in:

• Hot flushes and night sweats, often within weeks
• Sleep quality and energy
• Vaginal health and comfort
• Bone strength and reduced fracture risk
• Mood, focus and overall wellbeing

For women whose symptoms affect work, relationships and quality of life, MHT can be a highly effective option.

What are the risks and considerations?

Like all treatments, MHT carries some risks, and they vary with your age, health history and the type used. Understanding them in proportion matters, because fear of MHT is often larger than the evidence supports.

• Breast cancer. Combined oestrogen and progestogen therapy is associated with a small increase in breast cancer risk with longer-term use, and this risk reduces after stopping. Oestrogen-only therapy, used by women who have had a hysterectomy, carries little or no increased risk. To put the combined risk in proportion, it is broadly similar in size to the increase associated with being overweight or drinking alcohol regularly.
• Blood clots. The risk is higher with oral tablets and low with patches and gels, because transdermal forms bypass the liver.
• Stroke. The risk rises slightly with age, particularly when MHT is started after 60.

For most women under 60, or within 10 years of menopause, the benefits of MHT generally outweigh the risks when it is prescribed and monitored appropriately. The Australasian Menopause Society provides current Australian guidance on safety and use.

Who is a good candidate for MHT?

MHT may suit women with moderate to severe menopause symptoms who are under 60 or within 10 years of their last period, and who do not have conditions that make it unsuitable.

MHT may not be recommended for women with:

• A history of breast or ovarian cancer
• Unexplained vaginal bleeding
• A history of blood clots or stroke
• Severe liver disease

A doctor who prescribes MHT will assess your personal and family history and help work out whether it is appropriate for you. This is a shared decision, and you should never feel pressured into it or dismissed for choosing not to.

How do you get MHT in Australia?

In Australia, MHT is available by prescription only. Many women start with a GP, and some see a menopause-informed GP or specialist, particularly if symptoms are ongoing or complex. Since 1 July 2025, Medicare also covers a dedicated menopause health assessment, a longer appointment designed to review your symptoms, history and options properly, which can be a good place to begin.

The process usually involves:

• Booking an appointment with a GP, menopause gynaecologist or other menopause-informed clinician
• Discussing your symptoms and medical history
• Choosing the most appropriate type of MHT
• Ongoing review, usually every six to twelve months, to check how it is working and adjust the dose if needed

Our vetted directory lists GPs, gynaecologists and other practitioners with a genuine menopause focus, so you can find someone who understands current evidence and takes your symptoms seriously. Coverage is deepest in Melbourne and Victoria and is growing across other states, and telehealth is an option if it is hard to see someone in person.

How long can you stay on MHT, and how do you stop?

There is no fixed time limit. Many women use MHT for several years, and some continue longer if symptoms persist and the benefits still outweigh the risks. Australian guidelines do not set a maximum duration. What matters is regular review with your doctor, usually every six to twelve months, to check that continuing still makes sense for you.

When you do decide to stop, it is worth doing so with your doctor rather than abruptly, since some women find symptoms return for a time. Your doctor can talk through whether to reduce the dose gradually and what to expect.

Is MHT right for you?

Deciding whether to start MHT can feel overwhelming, especially with conflicting information online. The decision is individual and depends on your symptoms, your health history and your preferences. What matters most is how your symptoms are affecting your daily life, and whether treatment could improve your wellbeing. A menopause-informed clinician can help you weigh it up calmly, without pressure either way.

Key takeaways

• MHT, also known as HRT, is the most effective treatment for moderate to severe menopause symptoms.
• It comes in several forms, including patches, gels and sprays, tablets and vaginal oestrogen.
• Benefits include symptom relief, better sleep, and support for bone and long-term health.
• Risks exist but are generally small for healthy women under 60 when MHT is prescribed and monitored appropriately.
• There is an ongoing national shortage of oestrogen patches, and your pharmacist can often substitute an alternative without a new script.
• Always seek personalised advice from a doctor.

Frequently asked questions

Author: Sharryn Ludlow

Sharryn Ludlow is an Australian founder and strategy-and-operations practitioner. She is the founder of Menopause Resource Hub (AU), a curated directory helping women find menopause-informed support. Sharryn has worked across travel operations, group logistics, and project support for over 20 years, and is known for a direct, grounded style that cuts through noise and focuses on what works.