One really big question women ask themselves when they start their menopause journey is, ‘Should I go on to HRT?’.
While this article explores the possible answers to this question, before you get your hackles up, you must realise that this article is written by a Naturopath specialising in natural menopause.
Why is this important?
As with all information and opinions on the internet, this article will provide information from a perspective and viewpoint influenced by my qualifications in natural medicine, my clinical experience, my research into this topic, and, of course, my personal bias.
For anyone reading this article, I encourage you to read as widely as possible on HRT and make an informed and educated decision.
So, let’s begin.
What is HRT?
Now, relabelled Menopause Hormone Therapy (MHT), hormone replacement therapy is a relatively new way of ‘treating’ menopause. This prescribing philosophy is based on the theory that menopause is an oestrogen deficiency syndrome, therefore requiring ‘hormone replacement’.
First used in the 1960s, MHT gained popularity in the 1990s. The first clinical trials on its post-menopausal effects began in the late 1990s, so HRT (MHT) is a relatively new therapy.
Prescribing protocols of MHT have changed over the years, as have the quality of hormones available for prescription.
In the early days, the only MHT available was derived from a mare’s urine (yep, horses), and it was a conjugated oestrogen prescribed in isolation. Research in the 70s uncovered a necessity to co-prescribe progesterone (progestins) to prevent the increased risk of endometrial cancer.
Current prescribing for MHT often combines an oestrogen patch (to avoid excess strain on the liver) with oral progesterone.
What about bioidentical hormones? Are they the same?
Many practitioners (and even Naturopaths) will push for the use of bioidentical hormones. Bioidentical hormones also referred to as ‘nature-identical hormones’ or ‘body-identical hormones’, are presented as a ‘natural’ way to manage menopausal symptoms. However, this may seem misrepresentative of the treatment therapy.
The main difference between MHT and bioidentical hormones is that the structure of the latter is more in accordance with the natural hormones that your body manufactures. This then makes bioidentical hormones more recognisable by your body as hormones because, structurally, they are pretty close to what your body makes.
So they are natural, right?
While it is suggested that bioidentical hormones are more similar to the hormones that your body naturally produces, they are still prescribed based on the understanding that menopause is a hormone deficiency syndrome. Using these manufactured bioidentical hormones is a way to ‘replace’ the hormones that your body is ‘missing’. But are they really missing?
MHT prescribing and finding the sweet spot
You may have already seen some reports in the media about MHT and its ability to protect the body from common issues associated with declining oestrogen levels. These media broadcasts often emphasise the importance of MHT in preventing osteoporosis and cardiovascular disease. They will frequently push for the necessity to begin hormone therapy before a woman is 60 years old to avoid increasing cardiovascular risk.
This urgency is put on the ‘early dosing’ of MHT, then provides fuel for marketing the demand for women transitioning through menopause to make a quick decision.
(if you don’t do it now, it might be too late!)
Of course, this kind of marketing and messaging can have us midlife women asking ourselves:
Should I go on to HRT?
Now, the only person who can make this decision is you, and you must consider your health history and family genetics.
But there are three questions that I urge you to consider when you are making the decision as to whether you should go on to MHT (HRT):
Q1: What is menopause?
If you consider menopause to be a disease process and an oestrogen deficiency syndrome, then the general path is to use synthetic hormones to correct the deficiency.
But if you believe menopause to be a natural transition that occurs for women when they reach a certain stage in their lives, then synthetic hormones may NOT be your first choice.
Q2: What are the risks and benefits of using MHT?
While you may consider menopause to be a disease process OR a natural transition, there may still be personal reasons that you would consider using synthetic hormones. And weighing up the risks and benefits of hormone therapy requires careful consideration.
Q3: Is there some other way to manage your health during perimenopause?
Perhaps you are already set on using MHT to help with your transition through menopause, and you have weighed up the risks and the benefits. It’s then time to consider if there is some other way to support your body through your menopausal transition.
On top of everything else that may be going on for you at this time, making this decision to either use or not use hormone therapy during perimenopause is not something you should consider lightly.
But I will leave you with one last thing to consider:
There is no ‘one way’ to support your health during your menopausal transition. There is ALWAYS another way to do things. Different cultural approaches, ways of thinking, a different perspective, and modalities you can utilise.
*Consider your options, ask questions, and do your own research. *
How I can help with your menopausal transition
As I mentioned at the start of this article, I am a Naturopath specialising in women’s health during perimenopause; you may be interested in this article, which gives you some information on how a Naturopath can help with menopause:
Can a Naturopath Help with Menopause?
Plus, I have a comprehensive 12-week program to help you to master your menopausal transition. You can have a look at the program here:
Natural Menopause Mastery Program
Also, if you would like to discuss one-on-one consults, natural menopause courses, or just to find out if we’re a good fit, I welcome you to book a FREE Discovery Call to discuss your health and what you need to glide through menopause with grace and dignity.
I look forward to connecting with you soon.
The information provided in this article is for information purposes only and should not be taken as medical advice. We recommend you consult with a GP or other healthcare professional before taking action based on this article. While the author uses their best endeavours to provide accurate and true content, the author makes no guarantees or promises regarding the accuracy, reliability, or completeness of the information presented. If you rely on any information provided in this article, you do so at your own risk.
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