Hormone Replacement Therapy should only be used for the short-term relief of menopausal symptoms, say experts.
HRT has been linked to health problems
The new guidance suggests that if a woman has taken HRT for around five years, she should consider if it is in her best interest to continue.
The guidance, in a Royal College of Obstetricians and Gynaecologists book, follows a review of HRT research.
Recent studies suggesting health risks have led to a decline in HRT prescribing over the last two years.
HRT is used to treat symptoms of the menopause, such as hot flushes, insomnia, headaches and irritability.
But a major US trial of 11,000 women was halted earlier this year after evidence that taking an oestrogen-only pill could increase the risk of a stroke.
Another branch of the same trial - the Women's Health Initiative - which tested a combination pill was stopped in 2002 over similar concerns.
Long-term use of HRT has also been linked to an increased risk of breast cancer.
The latest guidelines are published in a new RCOG book, Menopause and Hormone Replacement.
They reflect recent recommendations made by the Committee on the Safety of Medicines.
The key recommendations are:
- HRT will continue to be prescribed for women with severe menopausal symptoms.
- For women who are not suffering from menopausal symptoms, the risks of taking HRT outweigh the benefits.
- That ultimately women should have the choice to take the drugs provided they understand the risks.
Professor Valerie Beral, director of Cancer Research UK's Epidemiology Unit at the University of Oxford, said: "This new report clearly lays out the risks and benefits associated with taking HRT.
"We know that the drug can offer short-term benefit for relieving menopausal symptoms but we also know that the longer women take HRT, the greater the risks of breast cancer and strokes."
Professor Shaughn O'Brien, the RCOG's junior vice president, said: "75% of women complain of significant menopausal symptoms.
"The short-term use of HRT for these women can be prescribed with relatively
"For longer-term therapy the risks really must be weighed up by the patient and her doctor together."