HRT Demystified: Understanding Your Options During Menopause
Here’s a topic that stirs quite a bit of debate – Hormone Replacement Therapy (HRT), now referred to as Menopause Hormone Therapy (MHT). Here’s the thing, I’m not here to tell you what you should or shouldn’t do. I’m here to arm you with facts, clear up some myths, and explore the options available to you so you can make an informed decision that is right for you.
The Menopause Spectrum
Menopause isn’t a one-size-fits-all deal. We will all experience it differently, just as we all experienced periods, fertility, pregnancy, breastfeeding and pretty much everything related to health and hormones differently.
About 30% of women will sail through this season of life, pretty much symptom-free. Most of us will face mild-moderate symptoms that will certainly be felt at some stage.
Then there are approx 30% of women who will experience symptoms so severe, it will significantly impact the quality of their day to day life.
No woman should have to “just deal with it” when it comes to debilitating symptoms. If your day to day is disrupted and you know you’re not feeling like yourself, then if HRT is an option for you, it can be life changing.
The Evolution of HRT
Let’s address the elephant in the room – the bad rap HRT got from The Women’s Health Initiative Study in the ’90s. It linked HRT to an increased risk of breast cancer, but here’s where context matters. The study used high doses of synthetic estrogen derived from pregnant horses, which is the old school HRT. And then the media incorrectly exaggerated the results. Shocking, I know!
Fast forward to today, and HRT options have evolved significantly, offering safer, lower-dose alternatives that align better with our bodies’ needs.
Today's HRT Options: Tailored and Safer
Modern HRT focuses on bio-identical hormones, including estradiol or estriol (forms of estrogen derived from plants) AND progesterone (not synthetic progestin which is found in the Pill and contraceptives), which can be administered through skin-absorbing methods like patches or creams, reducing the risk of side effects. Balancing estrogen with progesterone can be particularly beneficial, particularly for those in perimenopause, rather than estrogen alone.
A Personal Choice
Opting for HRT is deeply personal and varies from one woman to another. It’s about finding what works for your unique body and situation. Whether it’s estrogen alone, a combination of estrogen and progesterone, or progesterone alone, the key is to discuss these options with your healthcare provider, equipped with the knowledge of what’s available.
Be your own advocate and ask for what you want.
If you’re told that you are too young, it’s a part of life or some such other rubbish, or you’re given synthetic hormones, or put on the Pill (which puts you in a chemical induced menopause) or worse, antidepressants (if you aren’t suffering depression) then find another doctor up to date with women’s health.
There are some great doctors out there. Unfortunately, there are also a lot of dinosaurs.
Not All Hormones Are Created Equal
Steer clear from synthetic progestins and conjugated estrogens. What you want are body-identical options that mimic your natural hormones as closely as possible, starting with the lowest dose possible, minimising potential risks and side effects.
Personal and family medical history, age of natural menopause onset, and current symptoms play a significant role in determining the suitability of HRT.
How long do I take HRT for?
Current research recommends the lowest dose for the least amount of time. It suggests that five years of hormone therapy is generally sufficient to alleviate symptoms and starting therapy ten or more years after menopause may not be beneficial.
Now what is happening in the UK is interesting…. The recommendation in the UK is women can take HRT for life, to prevent osteoporosis and possibly dementia.
Now… my thoughts on this is, there are no long term studies (so are women in the UK currently the study?!) and we meant to have a natural decline in hormones. So why take them longer than necessary IF we are also prioritising a healthy diet and lifestyle.
Watch this space.
You're in Control
Remember, this journey is yours. You’re not locked into any decision. If HRT isn’t aligning with your body or your symptoms, it’s perfectly okay to reassess and explore other avenues.
Beyond HRT: Natural Support for Your Body
Whether you choose HRT or not, prioritising your health by supporting your body with good nutrition, making lifestyle changes that support sleep, exercise and stress management is key. Focus on addressing any health concerns now, maintain a healthy insulin response, thyroid support, gut health, and liver detoxification. Incorporating phytoestrogens (such as flaxseeds and organic soy) through food can also provide natural hormone balance.
Wrapping Up
YOU can make informed choices for your own health and well-being. Armed with knowledge, you can navigate the conversation about HRT with confidence and clarity.
If you’ve got questions or need support, I’m here for you. Drop a question on socials or send me an email. Remember, you’re not alone in this journey.
About Kylie Pinwill
Kylie is an accredited nutritionist and host of The Hormone Hub podcast – for women in perimenopause and menopause.
Kylie supports busy, driven women who are feeling lethargic and foggy, struggling with weight gain, bloating and hot flushes, to balance their hormones, reset their metabolisms and better manage stress so they can feel happier, more energised, and get on with living life.
For Kylie, this stage of life can be challenging but it doesn’t need to be.
She believes that we just need to do it differently.
