Hormone Replacement Therapy After Endometrial Cancer: Current Evidence and Treatment Recommendations

Endometrial cancer is the most prevalent gynecologic malignancy in developed countries, with an increasing incidence driven primarily by rising obesity and aging populations. While survival rates are high, particularly for early-stage, low-grade disease, many endometrial cancer survivors experience significant menopausal symptoms due to the definitive surgical treatments. Hormone replacement therapy (HRT) remains the most effective treatment for vasomotor and genitourinary symptoms of menopause; however, its use in women with endometrial cancer has been met with caution. This review synthesizes the current evidence, evaluates risk stratification models and offers a practical, patient-centered approach to the use of HRT in endometrial cancer survivors. PEER REVIEWED ARTICLE **Peer reviewers:** Prof. Andreas Günthert, Gynecological Tumor Center St. Anna, Lucerne, Switzerland Dr Eleftherios Pierre Samartzis, Gynecological Tumor Center, University Hospital Zurich, Zurich, Switzerland Received on December 15, 2025; accepted after peer review on February 23, 2026; published online on February 25, 2026.