Intervention

Hormone replacement therapy

Established evidence

Hormone replacement therapy restores hormones (e.g. testosterone, estrogen) that decline with age or deficiency. It is an established treatment for specific indications, not a proven general anti-ageing therapy.

Also known as: hormone replacement therapy, HRT, TRT, testosterone replacement therapy, menopausal hormone therapy, hormone optimization

What it is

Hormone replacement therapy (HRT) supplements hormones the body no longer makes in sufficient amounts — most commonly menopausal estrogen/progesterone, or testosterone for diagnosed male hypogonadism.

Why it matters for longevity

Sex hormones influence bone, muscle, metabolism and quality of life, so restoring deficient levels can ease symptoms and protect against problems like osteoporosis and the muscle loss that drives frailty.

What the evidence shows

For its established indications (menopausal symptoms, hypogonadism) HRT is well-validated, and a large 2023 trial found testosterone therapy did not increase cardiovascular events in men with hypogonadism. But the Women's Health Initiative showed risks depend on age, timing and formulation, and HRT is *not* proven to extend lifespan in people with normal hormone levels.

What to ask a clinic

Insist on proper diagnosis (symptoms plus lab confirmation), individualised risk assessment (clots, hormone-sensitive cancers) and monitoring. Be sceptical of blanket “optimise your hormones for longevity” marketing.

Sources & references

  1. Lincoff AM, et al. Cardiovascular safety of testosterone-replacement therapy. New England Journal of Medicine. 2023. doi:10.1056/NEJMoa2215025
  2. Rossouw JE, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women (Women's Health Initiative). JAMA. 2002. doi:10.1001/jama.288.3.321

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Educational information, not medical advice. Evidence ratings follow our methodology.