General Gynecology · Treatment
Hormone Replacement Therapy in Seoul: Benefits, Risks and Options
Hormone replacement therapy (HRT, also called menopausal hormone therapy) replaces the estrogen the ovaries no longer make, with progesterone added when you still have a uterus, to relieve hot flashes, night sweats, vaginal dryness and sleep problems and to prevent bone loss. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo prescribes individualized estrogen, progesterone and testosterone regimens by tablet, patch, gel or vaginal cream after assessing your personal benefits and risks.
Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026
At a glance
Key facts
The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.
- Main types: estrogen alone (after hysterectomy); estrogen plus progesterone (with a uterus); local vaginal estrogen; low-dose testosterone for low desire
- Routes: tablets, transdermal patches or gels, vaginal creams or tablets
- Best time to start: before age 60 or within 10 years of menopause for the most favorable balance of benefit and risk
- First visit: history, examination, ultrasound and blood tests as needed; about 30–45 minutes
- Review: at 3 months, then at least yearly
- Not suitable for: current or past breast cancer, active blood clots, recent stroke or heart attack, unexplained bleeding, active liver disease
- Prescribed by: Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist and sexual-medicine researcher
Hormone replacement therapy at a glance
Replaces estrogen, with progesterone if you have a uterus, to relieve menopausal symptoms and protect bone.
- hormone replacement therapy Korea
- HRT Seoul
- menopausal hormone therapy
- estrogen therapy
- estrogen patch
- testosterone for women
- Tablet, patch, gelRoutes
- Before 60 or within 10 yrsBest time to start
- 30–45 minFirst visit
- 3 months, then yearlyReview
- ScreenHistory, exam and blood tests.
- Choose the regimenEstrogen alone or with progesterone.
- Choose the routeTablets, patches, gels or vaginal.
- ReviewAt 3 months, then at least yearly.
Illustration: Somssi Women's Clinic, Seoul. Schematic, not to scale; your plan is set by Dr. Yoon Ho-joo after examination.
What is hormone replacement therapy?
Hormone replacement therapy restores some of the estrogen that falls away at menopause. Estrogen is the hormone that relieves hot flashes, night sweats, vaginal dryness and many sleep and mood symptoms, and that keeps bone dense. If you still have a uterus, a progestogen (progesterone or a synthetic equivalent) is added to protect the uterine lining, because estrogen on its own can thicken it and raise the risk of endometrial cancer.
For most healthy women under 60, or within 10 years of their last period, HRT is the most effective treatment for menopausal symptoms and its benefits outweigh its risks. The headlines of the early 2000s that frightened a generation away from hormones came from a study of older women on one specific regimen; later analysis showed the picture for younger, recently menopausal women is considerably more favorable.
Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD, who has published research on sexual desire disorder in Korean women and presented on menopause and sexual function at international congresses. For an overview of all menopause options, including non-hormonal and surgical care, read our menopause treatments page.
Who is a good candidate for HRT?
- Women with hot flashes, night sweats or sleep disturbance that affect quality of life
- Women with vaginal dryness, painful intercourse or recurrent urinary infections after menopause
- Women with early menopause (before 45) or premature ovarian insufficiency (before 40), for whom HRT until at least the average age of menopause is recommended to protect bone, heart and brain health
- Women who have had their ovaries removed
- Women at high risk of osteoporosis who cannot take other bone medicines
- Postmenopausal women with distressing low sexual desire, who may benefit from adding low-dose testosterone
Who should not take HRT?
Systemic hormones are generally avoided in women with:
- Current or past breast cancer, or other estrogen-dependent cancer
- A current or past blood clot in the leg or lung, or a known clotting disorder (transdermal estrogen may sometimes be considered after specialist review)
- A stroke or heart attack, especially recent
- Unexplained vaginal bleeding that has not been investigated
- Active liver disease
- Known or suspected pregnancy
Migraine with aura, high blood pressure, gallbladder disease, high triglycerides and a strong family history of breast cancer are not absolute barriers but change which type and route is chosen. Low-dose vaginal estrogen is considered safe for most of these women because very little is absorbed into the bloodstream.
Types, routes and how Dr. Yoon chooses
| Option | What it is | Typically chosen for |
|---|---|---|
| Estrogen only | Oral tablet, patch or gel | Women who have had a hysterectomy |
| Estrogen plus progestogen | Combined tablet, or estrogen patch/gel with oral micronized progesterone or a hormonal IUD | Women with a uterus; continuous combined after menopause, cyclical in perimenopause |
| Transdermal estrogen | Patch or gel absorbed through the skin | Women with migraine, higher clot risk, high triglycerides, gallbladder disease or obesity, because it bypasses the liver |
| Local vaginal estrogen | Cream, tablet or ring with very low systemic absorption | Vaginal dryness, painful sex and urinary symptoms, alone or alongside systemic therapy |
| Low-dose testosterone | Transdermal, at roughly one tenth of male doses | Postmenopausal hypoactive sexual desire disorder once other causes are addressed |
| Tibolone | Synthetic steroid with estrogenic, progestogenic and androgenic effects | Some postmenopausal women wanting a single tablet with libido benefit |
The clinic's postmenopausal program tailors the regimen to early menopause, surgical menopause after hysterectomy or natural menopause, and offers tablets or vaginal creams depending on your symptoms. Dr. Yoon pairs hormone treatment with advice on balanced nutrition and aerobic exercise, and, where atrophy or laxity has changed the vagina physically, with the reconstructive options described on our vaginal stenosis and vaginoplasty pages.
What happens at the visit
The first consultation lasts about 30–45 minutes. Dr. Yoon reviews your symptoms, periods, personal and family history of breast cancer, blood clots, heart disease and osteoporosis, and your sexual health, which is treated as a normal part of the conversation rather than an afterthought. Examination includes blood pressure, a vaginal assessment for atrophy and a pelvic ultrasound to measure the uterine lining and check the ovaries.
Blood tests are not required to diagnose menopause over 45, but thyroid function, lipids, glucose and, when testosterone is being considered, baseline hormone levels may be checked. You should be up to date with mammography and cervical screening; both can be arranged. You leave with a prescription, written instructions and a review date.
Timeline: what to expect
| When | What to expect |
|---|---|
| Weeks 1–2 | Breast tenderness, mild nausea, bloating or spotting are common while your body adjusts |
| Weeks 2–4 | Hot flashes and night sweats begin to ease; sleep often improves first |
| Weeks 6–12 | Vaginal symptoms improve with local or systemic estrogen; dose adjusted if needed |
| 3 months | Review visit: symptoms, side effects, bleeding pattern, blood pressure |
| Yearly | Full review of benefits and risks, breast and cervical screening status, bone health; decide together whether to continue |
Benefits
- Relief of hot flashes and night sweats in the great majority of women, usually within weeks
- Better sleep, and improvement in mood and concentration symptoms linked to menopause
- Relief of vaginal dryness, painful intercourse and some urinary symptoms
- Prevention of bone loss and reduction in fractures while treatment continues
- In women who start early, a likely reduction in heart disease and overall mortality compared with no treatment, although HRT is not prescribed solely for that purpose
- Possible improvement in sexual desire and response, particularly when testosterone is added for diagnosed low desire
Risks and how we reduce them
- Breast cancer: combined estrogen-progestogen therapy is associated with a small increase in risk after about five years of use (on the order of a few extra cases per 1,000 women over that period); estrogen alone shows little or no increase in most studies. We use the lowest effective dose, favor micronized progesterone, review annually and keep mammography up to date.
- Blood clots and stroke: oral estrogen roughly doubles a small baseline clot risk; transdermal estrogen appears not to, and is preferred for women with any risk factors.
- Endometrial cancer: only with estrogen taken without a progestogen when the uterus is present; prevented by combined therapy or a hormonal IUD. Any unexpected bleeding after the first six months is investigated with ultrasound and, if needed, biopsy.
- Gallbladder disease: more likely with oral than transdermal estrogen.
- Testosterone: acne, unwanted hair growth or voice change if doses are too high; avoided by low dosing and blood level checks.
- Starting late: beginning systemic HRT after 60 or more than 10 years from menopause carries higher cardiovascular risk and is considered only with care.
The clinic's own guidance is to keep the duration of combined therapy under regular review and to be cautious about starting systemic hormones in the late fifties or beyond; international guidelines do not set an arbitrary stopping age but recommend an annual, individualized reassessment.
Why international patients choose Somssi
Many expatriates arrive with an HRT prescription from home and need a doctor who can continue, adjust or convert it to products available in Korea. Dr. Yoon offers that in English, with the added perspective of a gynecologist who also treats the physical vaginal changes of menopause surgically when needed. The clinic is 100 m from Gangnam Station Exit 1, has been a Ministry of Health and Welfare registered institution for foreign patients since 2011 and a Seoul Medical Tourism cooperation clinic since 2016.
Once stable, follow-up can often be handled remotely. Read more on our international patients page, see the clinic's wider hormonal imbalance treatments, or contact the clinic to bring your current prescription for review.
Private consultation
Talk it through with Dr. Yoon's team
English-speaking coordinators, a written treatment plan and a clear quote after your consultation. Same-day discharge for most procedures.
Mon, Tue, Wed, Fri, Sat 09:30–18:00 (KST). Closed Thu, Sun and holidays. 7F Sangkyung Building, 120 Teheran-ro, Gangnam-gu, Seoul.
Dr. Yoon Ho-joo, MD, PhD
OB/GYN specialist, Catholic University of Korea. Founder of Somssi Women's Clinic (2000). Published on female sexual function after reconstructive vaginal surgery; speaker at ESSM, ISSWSH, WAS and SMSNA.
Questions patients ask
Frequently asked questions
Short, honest answers. For anything personal, a consultation is the right place to ask.
Is HRT safe?
For most healthy women who start before 60 or within 10 years of menopause, yes: the benefits for symptoms, sleep and bone outweigh the small risks. The main concerns are a modest increase in breast cancer risk with long-term combined therapy and a clot risk with oral estrogen, both of which are reduced by individual assessment, transdermal routes and annual review. Women with breast cancer, clots or stroke are generally advised against systemic HRT.
What is the difference between HRT and bioidentical hormones?
"Bioidentical" simply means molecularly identical to the body's own hormones. Regulated products such as estradiol patches and gels and micronized progesterone are bioidentical and are what we usually prescribe. Custom-compounded "bioidentical" mixtures sold with saliva testing are not better regulated or safer, and major societies advise against them. We use licensed products with known doses.
How long can I stay on HRT?
There is no fixed limit. Guidelines recommend continuing for as long as the benefits outweigh the risks for you, reassessed at least every year, rather than stopping at a particular age or after a set number of years. Some women use it for a few years; those with early menopause continue to at least 50. When stopping, gradual tapering reduces the return of hot flashes.
Will HRT make me gain weight?
Studies do not show that HRT causes weight gain; the weight and shape changes of midlife are driven by age, muscle loss and lifestyle, and hormone therapy if anything slightly limits the shift of fat to the abdomen. Bloating and breast fullness in the first weeks are common and usually settle. Strength training and protein intake matter more than the prescription.
Can I take HRT if I have had a hysterectomy?
Yes, and it is simpler: without a uterus you need estrogen only, with no progestogen, which removes the component most linked to breast cancer risk. If your ovaries were also removed before the natural age of menopause, HRT is actively recommended until at least 50 to protect your bones, heart and brain.
Does HRT help with low sex drive?
Partly. Estrogen relieves dryness and pain, improves sleep and reduces flashes, all of which help desire indirectly. If distressing low desire persists after these are treated, low-dose testosterone can be added for postmenopausal women; it is given at about a tenth of male doses with blood level monitoring. Dr. Yoon's published research on hypoactive sexual desire disorder in Korean women informs this part of the clinic's program.
Keep reading
Related treatments and guides
- Menopause Treatments — the whole-person overview including non-hormonal and surgical options
- IUD Insertion and Removal — using a hormonal IUD as the progestogen component of HRT
- Can Vaginal Rejuvenation Help With Menopause-Related Changes? — what energy-based treatments add to estrogen therapy
- Vaginal Stenosis — surgical dilatation when atrophy has narrowed the vagina
- PCOS Management — hormonal care for a different stage of life at the same clinic
- Hormonal Imbalance Treatments — the clinic's broader hormone care
- Dr. Yoon Ho-joo — credentials and research in sexual medicine
Sources and medical review
- American College of Obstetricians and Gynecologists (ACOG), Practice Bulletin on hormone therapy for menopausal symptoms
- Dr. Yoon Ho-joo, study of hypoactive sexual desire disorder in 217 Korean women attending a community gynecology clinic, Journal of Obstetrics and Gynaecology (SCI), 2018, DOI 10.1080/01443615.2017.1389866
- World Health Organization (WHO), menopause fact sheet
Next step
A consultation first. A decision only when you are ready.
Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.
