Hormone replacement therapy (HRT) can be a confusing topic. For decades, it was touted as not just a way to make menopause easier to get through but as a way to maintain vibrant health post-menopause. However, the expected health benefits failed to appear and some studies reported its use increased the risk of heart disease. Currently, doctors think it is safe for most women to take HRT short-term in order to relieve menopausal symptoms.
Who should consider taking HRT
If you are experiencing moderate to severe hot flashes, troublesome vaginal dryness, “brain fog”, insomnia, and other symptoms of menopause that are severe enough to disrupt your life, you should consider taking HRT.
Who should not take HRT
If you have a history of heart attack, heart disease, or a blood clot you should not take HRT.
What type to take
Doctors suggest taking the lowest dose of HRT for the shortest period of time that is capable of relieving menopausal symptoms. Oral patches can relieve most menopausal symptoms with fewer systemic effects than oral medications. Creams, rings, and tablets that are placed directly in the vagina can eliminate vaginal symptoms with little to no systemic exposure to the hormones. Whether you need just estrogen or a combination of estrogen and a progestin depend on whether you still have a uterus, since estrogen given alone can increase the risk of developing endometrial cancer.
What about bioidentical hormones?
Although there has been much hype about bioidentical hormones being safer and more effective than regular HRT, the evidence says otherwise. Most of the FDA-approved hormones for HRT are chemically identical to the hormones found in the human body. There are also some serious concerns about “bioidentical” hormones. One concern is that they don’t use FDA-approved commercial products and instead compound their own, and there is no proof these products are effective or safe. The other is that often the dose suggested is based on saliva tests of hormone levels, but hormone levels in saliva have little to no correlation with hormone levels in the rest of the body.
Take the risk of heart disease seriously
Heart disease is generally thought of as a “man’s disease” but it is the number one cause of death of women. The risk dramatically increases after menopause whether or not HRT is used to manage menopausal symptoms. Simple lifestyle changes such as regular exercise, not smoking, and eating five servings of vegetables and two servings of fruit every day can not only reduce the risk of heart disease but may also help relieve menopausal symptoms.
If you are suffering from serious menopausal symptoms and don’t have a history of heart disease, talk to your doctor about whether HRT is right for you.