Managing Menopause: Are hormones right for you?

By definition, menopause is the absence of a period for 12 months or more. For anyone nearing menopause, you know it’s not as simple as it sounds. Perimenopause can begin in our 30s, and with it comes a whole host of symptoms. As our ovaries stop producing estrogen and natural hormone levels decline, the symptoms start to present themselves.

The transition can last up to 10 years, leaving much of our midlife impacted by these changes. The average age of menopause is 51, but the process is unique for everyone. 

It’s a significant and important women’s health change that directly impacts our quality of life. Some common symptoms include:

• Hot flashes

• Night sweats

• Mood swings, irritability, depression, or anxiety

• Headaches

• Insomnia, sleep problems, or changes in sleep 

• Vaginal dryness, decrease in libido

• Brain fog, memory loss, fatigue

• Joint pain

• Hair loss

• Weight changes, inability to lose weight

• Increased risk of heart disease, Alzheimer's, and osteoporosis

Depending on your age, you may be all too familiar with this list already! And as we can tell – the symptoms can range from uncomfortable to debilitating at times. And as women are living longer lives (anywhere from ⅓ to ½ of our lives can be spent in menopause!) it becomes more important to make those years more enjoyable.

Estrogen and HRT

Estrogen and Hormone Replacement Therapy (HRT) was commonly prescribed to increase the quality of life for women for years, starting around 1940. Women were happy with the experience, and it was doing its job!

Then the Women’s Health Initiative (WHI) study came out. It was a large study of over 160,000 women taking combined HRT called prempro, which consisted of synthetic estrogen (premarin) and synthetic progesterone (medroxyprogesterone) taken orally.

The study was cut short in 2002 due to safety issues and an increased risk of breast cancer, heart disease, stroke, and blood clots. This caused a huge scare, and women were pulled off hormones immediately. The media sensationalized this study and scared women and doctors, and HRT was deemed dangerous across the board. 

I remember this time very clearly. I was an impressionable young intern and just learning about hormones for menopause. When the study came out, I quickly learned that hormones are bad and not to be used. But, are they really? In my training in functional medicine I’m seeing a very different side to hormones and unlearning some of what was indoctrinated in my medical training.

Here are the results of the WHI that caused the study to be stopped prematurely and hormones to be deemed dangerous: (please use emojis for all the bullet points in this document)

• Out of every 10,000 women, there were:

• 7 more heart attacks

• 18 more blood clots

• 8 more strokes

• 8 more breast cancers

• 6 less colon cancers

• 6 less hip fractures

• 97.5% of women had no bad outcome

The WHI began to investigate further and addendums were coming out to the previous results. We started to see the problems with the original study:

• Using a synthetic product 

• Progestins (used in the study) have now been shown to increase the risk of breast cancer

• Progesterone (used in the bioidentical product prometrium) does not

• Using it orally

• Oral estrogen increases inflammation and the risk of clotting to result in heart attack, stroke or blood clot

• Taking estrogen topically is much safer and can actually promote health

So there are safe and quite beneficial ways to use hormones. However – the stigma and negative reputation of HRT has continued to persist, and many still view it as dangerous. 

What are the benefits of using estrogen postmenopausally?

• Good for the heart

• Good for the brain

• Lowers inflammation

• Keeps the bones strong

• Improves cholesterol

• Helps with all the symptoms of menopause 

• Has over 400 functions in the body

As with any medication and treatment, there are still potential risks and it’s a highly personalized decision to be made with your doctor after weighing the benefits and risks. It is not for everyone. But it is also not the villain it was made out to be.

Lastly, hormone replacement is not a quick fix that allows us to ignore our lifestyle. The role of a healthy diet, proper exercise, good quality sleep, and stress management is still critical and vital to our well-being. But beyond lifestyle, hormone replacement may have many benefits. 

If you need some support in understanding your hormones, we are here to help.

Schedule a discovery call with us today!