Not Your Mother's Menopause: Navigating Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) has become a hot topic these days, and rightfully so. Over 25 years ago when I first began practicing, HRT was routinely prescribed for women not only to alleviate symptoms but also for disease prevention. However, in 2002, the findings of the Women's Health Initiative study spread fear and panic about the safety of HRT, leading to its abrupt cessation of use.

Since then, many of the findings of that study have been disputed, and follow-up studies have shown hormone replacement therapy to not only be safe but also highly impactful on a woman’s quality of life and health through her menopausal years. In my private integrative medicine practice, the demographic is largely perimenopausal through postmenopausal women. Day in and day out, I witness women struggling in a body they don’t recognize, feeling as if they're losing their minds. This prompted me to further my education and knowledge about menopause and hormones.

Here are some important points to note about hormone replacement therapy and menopause:

1. It’s not one size fits all. Just like we are all unique, our menopause course and what treatment options best suit us will be highly individual.

2. There are various options available, including oral medications, creams, patches, IUDs, supplements, and bioidentical compounds.

3. It may take time to adjust and try different formulations to find what works best for each individual woman, and those needs may change over time.

4. You can start postmenopausal HRT during your perimenopausal years. The average age of menopause is 52, and women can experience symptoms of perimenopause for years prior to this. By the time your periods begin to change, you are often in late perimenopause.

"Why Can't I Get Help?"

You may encounter providers who tell you that HRT is unsafe, that you are not in perimenopause if you are cycling regularly, or who offer antidepressants and sleep aides but won’t address hormones. This isn't because they are not good providers but rather because education in this area is sadly lacking. Surprisingly, only 7% of internal medicine and OB/GYN providers feel confident in providing menopause care even though they recognize its importance.

My best advice to my patients and any woman who will listen to me (I’m obsessed with all things menopause) is to advocate for yourself. Your symptoms are not in your head, and you're not crazy. You are not just an overwhelmed busy mom. Your symptoms are real, and you don’t have to continue feeling this way. Find a provider who specializes in menopause and HRT. One resource is the North American Menopause Society webpage, which has a search engine for providers near you.

HRT is not magic. Although it can help with the root cause of symptoms, to truly thrive and feel your best during this time, you also have to approach your lifestyle. Different ways our bodies need nourishment, exercise, and balancing insulin and cortisol are important considerations during this time.

This should not be “game over” time. There are so many incredible things about this stage in our lives and this transition. We get to decide what we want for this next part of our lives. It can and should be amazing. Most of us have been taking care of others and placing ourselves on the back burner. This is the time to invest in ourselves.

If you or anyone you know is looking for more support and information, join the waitlist for Faded to Fabulous, a comprehensive online menopause program due to launch May 11th. Myself and my co-creator, Kim Lovely  (who is a Registered Dietitian and Certified Life Coach.) cover EVERYTHING from hormones to nutrition to sexuality to skin care. We have a panel of experts from various modalities who are speakers during various modules. The link below will get you on the waitlist and we will send you a free menopause symptom checklist. 

fadedtofabulous.com