Hormone replacement therapy is shedding old baggage as the FDA relaxes its strictest warning labels on several products, while testosterone therapy surges in popularity.
But are these truly one-size-fits-all fixes? The conversation around hormone replacement therapy (HRT) is shifting as regulators and patients reassess long-held concerns. In February 2026, the US Food and Drug Administration approved labelling changes to six menopausal hormone therapy products, removing black box warnings — its strongest caution — about cardiovascular disease, breast cancer and probable dementia. At the same time, testosterone replacement therapy (TRT) is booming: prescriptions climbed from 7.3 million in 2019 to more than 11 million in 2024.
HRT is used when the body no longer produces sufficient hormones and is most often prescribed to ease menopause symptoms. Hong Kong-based general practitioner Dr Laurena Law prefers the term menopause hormone therapy (MHT) and calls her own experience with it “life-changing”, crediting it with lifting night sweats, debilitating fatigue and mental darkness — negative thoughts, feelings of hopelessness and a general sense of unease
Dr Law assesses each patient holistically: lifestyle habits, medical and family history, current medications and supplements, and whether screenings such as mammograms, Pap smears and colon checks are up to date
WHAT MHT DOES FOR WOMEN
During perimenopause and menopause, levels of hormones — mainly oestrogen — fluctuate dramatically.
In MHT, oestrogen is not replaced so much as supplemented to smooth out this hormonal roller coaster, Dr Law explains. Delivered as tablets, gels, creams, patches or pessaries, MHT can ease hot flashes, unexplained tiredness, joint stiffness, insomnia, mood swings and irritability.
Women typically seek treatment for moderate to severe menopausal symptoms, to help prevent osteoporotic fractures, or to address low libido, sometimes with added testosterone under medical supervision. Dr Law assesses each patient holistically: lifestyle habits, medical and family history, current medications and supplements, and whether screenings such as mammograms, Pap smears and colon checks are up to date. She then uses a validated menopause rating scale to gauge symptom severity and guide discussion of options.
TESTOSTERONE THERAPY: MORE THAN A QUICK FIX FOR MEN
For men, TRT refers to the use of prescription doses of testosterone to restore serum total or “free” testosterone — the portion not bound to proteins — back into normal levels, says Dr Melvin Tan of Pulse Clinic Singapore. It also improves some symptoms present in testosterone deficiency syndrome (TDS), and is usually administered through topical, subcutaneous or intramuscular methods and, less commonly, through oral formulations.
Men commonly seek evaluation for shifts in mood, energy, fitness or sexual function that could suggest TDS, Dr Tan notes. Some, however, arrive without symptoms but want to “see if there’s anything off-kilter” in their hormone profile — a mindset he cautions against without clear indications. He stresses that TRT should follow a comprehensive workup, including hormonal testing along the brain-testicular axis to rule out other causes, and must be closely supervised to monitor benefits and risks.
MYTHS, MISCONCEPTIONS AND THE LIFESTYLE PIECE
Dr Law hears recurring myths: that women are “too young” for therapy, that MHT is inherently dangerous, or that they should simply push through symptoms.
She emphasises acknowledging these fears, offering both hormonal and non-hormonal approaches, and underlines that there is no one-size-fits-all solution.
For men, Dr Tan often must disentangle fatigue or erectile dysfunction from an automatic diagnosis of low testosterone, considering sleep, diet, exercise, work demands and mental health.
Regardless of whether hormones are prescribed, both doctors agree that lifestyle is the foundation. Small, sustainable shifts in eating, movement, sleep and stress management can compound over time, easing symptoms today while lowering the risk of future disease.
WELLNESS TIPS
Start with the right questions
- Ask what your actual diagnosis is, which hormones are low and why they might be out of range.
- Clarify whether you’re a candidate for menopausal hormone therapy, testosterone therapy, or a nonhormonal approach.
Expect a tailored plan
- A good workup includes medical and family history, current meds and supplements, and up-to-date
screenings such as mammograms and Pap smears. - Dosage, delivery method and duration should be individualised and reviewed regularly, not copied from a friend’s prescription or online protocol.
Know when testosterone helps — and when it doesn’t
- For men, TRT should follow clear symptoms and lab-confirmed testosterone deficiency, plus tests along the brain–testicular axis.
- Be wary of “low T” marketing if you’re mainly dealing with stress, poor sleep, weight gain or relationship issues