Hormone replacement therapy statistics 2026: HRT use since the WHI, the FDA label change and telehealth

annual US hormone therapy prescriptions in 1999, up from 58 million in 1995¹

This represented approximately 15 million women per year, and prescriptions stayed stable through June 2002.

drop in Prempro prescriptions in January-June 2003 compared with January-June 2002¹

Premarin prescriptions fell 33% over the same period, following the July 2002 publication of WHI trial results.

postmenopausal women aged 50 to 79 were enrolled in the WHI estrogen plus progestin trial²

The trial was stopped on May 31, 2002 after a mean of 5.2 years of follow-up because invasive breast cancer exceeded the stopping boundary.

hazard ratio for invasive breast cancer with estrogen plus progestin vs placebo in the WHI trial²

Absolute excess risks per 10,000 person-years were 8 more invasive breast cancers, 7 more coronary heart disease events, 8 more strokes and 8 more pulmonary emboli, with 6 fewer colorectal cancers and 5 fewer hip fractures.

was the average age of women in the WHI study, over a decade past the average age of menopause³

drop in age-adjusted US breast cancer incidence in 2003 compared with 2002⁴

The decrease was seen only in women 50 and older and was temporally related to the first WHI report and the drop in HRT use.

all-cause mortality with hormone therapy vs placebo over 18 years of cumulative follow-up in the two WHI hormone trials⁵

Hazard ratio 0.99 among 27,347 women randomized between 1993 and 1998 and followed through 2014.

of US postmenopausal women were using menopausal hormone therapy in 2020, down from 26.9% in 1999⁶

NHANES prescription data on 13,048 postmenopausal women, 1999 to March 2020.

of non-Hispanic Black postmenopausal women were using hormone therapy in 2020, down from 11.9% in 1999⁶

Over the same period use fell from 31.4% to 5.8% among non-Hispanic White women and from 13.8% to 2.6% among Hispanic women.

of commercially insured and Medicare Advantage women aged 40 and older used systemic hormone therapy in 2023, down from 4.4% in 2007⁷

OptumLabs claims; use defined as at least 180 days of filled prescriptions in a year.

of insured women aged 50 to 54 used systemic hormone therapy in 2023, down from 5.8% in 2007⁷

women ages 46 to 65 received a hormone therapy prescription in 2020, when about 41 million US women were ages 45 to 64⁸

estimated US prescriptions for estradiol in 2024, for an estimated 4,092,467 patients⁹

Estimate derived from the Medical Expenditure Panel Survey; it covers all estradiol prescriptions, not only those for menopause.

is when the FDA announced it was initiating removal of the broad boxed warnings from HRT products for menopause³

The FDA said it acted after a review of the scientific literature and an expert panel held in July 2025.

menopausal hormone therapy products had approved labeling changes by February 12, 2026, covering all four categories of HRT⁸

Risk statements on cardiovascular disease, breast cancer and probable dementia were removed from the boxed warning.

drug companies had submitted proposed HRT labeling changes at the FDA's request as of February 2026⁸

of menopause onset or before age 60 is when FDA labeling will recommend starting HRT³

is the reduction in cardiovascular disease risk the FDA's announcement said women may achieve with HRT; it also cited 35% for Alzheimer's disease and 50% to 60% for bone fractures³

These figures are as stated in the FDA/HHS announcement. For comparison, the 2002 WHI trial of estrogen plus progestin in women averaging 63 years old reported a hazard ratio of 1.22 for total cardiovascular disease.

manufacturers of estradiol transdermal patches the FDA said it was working with to increase availability as demand rose in 2026¹⁰

Reported by Urology Times in September 2026, citing an FDA update on estradiol patch availability.

of women seen in US outpatient care were using hormone therapy in April 2026, up from 1.7% in January 2017¹¹

Epic Research analysis of 163,348,471 adult women in the Cosmos database. Use held near 1.8% to 1.9% through 2022, then climbed steeply from 2023.

women aged 45 to 54 were using hormone therapy by April 2026, up from about 24 per 1,000 in January 2017¹¹

Women aged 45 to 54 saw the largest relative rise of any age group, nearly tripling.

rise in use of transdermal hormone therapy such as patches and gels, from 0.33% to 1.17% of women in outpatient care (2017 to 2026)¹¹

Vaginal products nearly tripled, from 0.45% to 1.26%.

women had an estrogen-based HRT prescription in February 2026, up from 11.5 per 1,000 in January 2018¹²

Truveta Research analysis of women 18 and older; preliminary and not peer reviewed. Overall, about 2 in 100 women had evidence of estrogen-based HRT use.

increase in estrogen-based HRT prescribing among women aged 45 to 54 between July 2025 and February 2026¹²

This window spans the FDA expert panel (July 2025) and the start of boxed warning removal (November 2025). In February 2026, 1 in 20 women aged 45 to 54 had evidence of an estrogen-based HRT prescription.

women: the rise in estrogen patch dispensing between 2018 and February 2026, making the patch the most common form of HRT¹²

Oral HRT dispensing fell from 10.4 to 8.6 per 1,000 women over the same period.

patients have been served by Midi Health, a virtual menopause and midlife care company, as of August 2026¹³

Company figure reported by Femtech Insider.

valuation at which Midi Health raised a $100 million funding round in 2026¹³

is the year Hims & Hers launched access to menopause and perimenopause support offerings on its telehealth platform¹⁴

Stated in the company's annual report for fiscal 2025, alongside testosterone offerings.

of US family medicine, internal medicine and OB-GYN residents said they felt adequately prepared to manage women experiencing menopause¹⁵

2017 survey; 34.4% of 183 respondents said they would not offer hormone therapy to a symptomatic, newly menopausal woman without contraindications.