What is the MHT decision tool and how will it help me?

The planned tool is being designed to help women and their GPs weigh up the individual benefits and risks of menopausal hormone therapy based on a woman's specific health profile, symptoms, and values. The aim is to replace the vague, often anxiety-laden conversation that currently happens at the GP desk — where outdated risk figures from the 2002 Women's Health Initiative study still circulate — with a structured, grounded in current evidence framework. It does not exist yet; the funded research project is in development.

Is MHT safe? I've heard it causes cancer.

The risk picture for MHT is more nuanced than the fear framing that emerged after 2002. Current evidence distinguishes between different formulations, routes of administration, duration of use, and a woman's individual baseline risk profile. The Australasian Menopause Society and RACGP guidelines both support individualised MHT discussion in general practice for eligible women. No blanket safety verdict applies across all women and all formulations — which is precisely why a structured decision tool is needed.

A government-backed MHT decision tool is coming. Here's why it matters.

What just happened

The federal government announced this week that it is funding the development of Australia’s first grounded in current evidence shared decision-making tool for menopausal hormone therapy (MHT). The investment — $13.7 million through the NHMRC Partnership Project scheme, with a further $17.4 million in partner funding — will be led by Professor Martha Hickey, Director of the Women’s Gynaecology Research Centre at the Royal Women’s Hospital and the University of Melbourne.

Professor Hickey’s framing of the gap being addressed was direct: “This project will be the first grounded in current evidence tool, co-designed with consumers and clinicians to empower women to make informed choices.”

The word first is doing real work in that sentence. In 2026, there is no standardised, grounded in current evidence decision aid that a GP in general practice can open with a menopausal patient to systematically weigh her individual benefits and risks of MHT. What exists instead is a clinical conversation held against a backdrop of contradictory headlines, outdated risk estimates from a 2002 US study, and — for many women — accumulated anxiety about cancer and heart disease that may no longer reflect the actual evidence landscape for their specific situation.

That conversation gap has measurable consequences. Approximately one in four women experience menopausal symptoms severe enough to disrupt daily life. MHT is the most effective treatment for vasomotor symptoms such as hot flushes and night sweats. Yet research has found that Australian women remain hesitant about MHT — not primarily because they have weighed the evidence and declined, but because the information available to them is fragmented, frightening, and frequently out of date.

The both-and

Why hesitancy persists — and why it is understandable

The 2002 Women’s Health Initiative (WHI) study fundamentally reshaped how both clinicians and the public thought about MHT. The WHI found increased risks of breast cancer, coronary heart disease, and stroke in women taking a combined oestrogen-progestogen oral preparation. Headlines were alarming. MHT prescribing dropped sharply. That response was not irrational given what clinicians knew at the time.

What has shifted since 2002 is considerable. Subsequent analysis showed that the WHI results applied primarily to older women initiating oral combined MHT more than ten years after menopause — a population quite different from the typical candidate for MHT in general practice today. More recent evidence distinguishes between formulation (oestrogen-only vs combined), route of administration (oral vs transdermal), duration, timing of initiation relative to menopause, and individual baseline risk. The RACGP’s current guidance on managing menopause supports individualised MHT discussion and reflects this more differentiated evidence base.

This is not a simple “MHT is safe” or “MHT is dangerous” story. It is a story about individualisation — about a clinical decision that requires weighing a specific woman’s symptom burden, her baseline risks, her values around treatment, and the best current evidence for her specific formulation and route. That is precisely what a structured decision tool is designed to support.

What the funding does — and doesn’t — change right now

The funding announced this week is for research and tool development, not deployment. There is no product available yet, and no announced timeline for public release. The $13.7 million investment will fund the research process: evidence review, co-design with consumers and clinicians, testing, and validation. This is the right sequence — a poorly designed decision aid can be worse than no aid at all if it oversimplifies individual risk profiles or is not calibrated to the Australian clinical context. It is also, necessarily, a slow process.

In the interim, the evidence base for individualised MHT conversations has not changed. Three new MHT formulations have recently been listed on the MBS, improving access to options with different risk profiles. The Australasian Menopause Society and Jean Hailes for Women’s Health both publish consumer-facing resources that reflect current evidence — they are not decision tools in the structured sense, but they are a significantly better starting point than many of the resources circulating online.

My two cents

For a woman in her 40s or 50s who is managing significant menopausal symptoms and has been hesitant to raise MHT with her GP — or has been told it is “risky” without a clear explanation of what that means for her specifically — this announcement is relevant context for a conversation that is worth having now, not waiting years for the tool to arrive.

The conversation worth starting is: “I am having symptoms that are affecting my daily life. I want to understand whether MHT is a reasonable option for me, and what my individual risks and benefits look like.” That conversation is within the scope of RACGP guidelines right now. It does not require a new government tool — it requires a GP who has time and current knowledge, and a patient who knows the conversation is worth having.

What the new tool will eventually add is structure and standardisation: a framework that makes the individual risk-benefit analysis visible and discussable rather than held loosely in a ten-minute consultation. That matters enormously for the women who have multiple GP visits without the conversation ever being properly opened, and for the GPs who are navigating the same complexity under time pressure. The investment is well targeted. The need is real.

Verdict: yes — worth knowing about.

Sources cited

“Government backing for menopause support tool” — RACGP newsGP, 23 June 2026. https://www1.racgp.org.au/newsgp/clinical/government-backing-for-menopause-support-tool
NHMRC Partnership Projects scheme. https://www.nhmrc.gov.au/funding/find-funding/partnership-projects
Australasian Menopause Society — patient information. https://www.menopause.org.au
Jean Hailes for Women’s Health — menopause. https://www.jeanhailes.org.au/health-a-z/menopause
RACGP — Managing menopause guidelines. https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/managing-menopause