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How HRT Works Hormone replacement therapy (also known as Menopause Hormone Therapy MHT) involves the use of estradiol (estrogen) with or without progesterone, and it directly addresses the hormonal root cause of menopausal metabolic changes: Reduces visceral fat accumulation: Research from the OsteoLaus cohort found that current HRT users had significantly lower visceral adipose tissue, BMI, and abdominal fat mass compared to never-users [7]