BMJ

Large cohort study finds menopausal hormone therapy doesn’t increase mortality risk

February 19, 2026

A nationwide Danish cohort of >876,000 women found no increase in all‑cause mortality among menopausal hormone therapy (MHT) users. After adjustment, MHT wasn’t associated with higher mortality (adjusted hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.93–0.98) despite a higher crude mortality rate (54.9 vs. 35.5 deaths per 10,000 person‑years). Mortality remained neutral across durations of use, including ≥10 years (adjusted HR, 0.98; CI, 0.90–1.07), and cause‑specific mortality (e.g., cardiovascular, cancer) didn’t differ. Women aged 45 to 54 who underwent bilateral oophorectomy had a 27% to 34% lower mortality hazard with MHT.

Clinical takeaway: For appropriately selected women without contraindications, these findings support continued guideline-aligned use of MHT. Clinicians can reassure patients that current evidence does not show increased long‑term mortality risk.

Source:

Mikkelsen AP, et al. (2026, February 18). BMJ. Menopausal hormone therapy and long term mortality: nationwide, register based cohort study. https://www.bmj.com/content/392/bmj-2025-085998