can hrt reverse menopause
How does HRT affect menopause? What are the options and risks?
Hormone replacement therapy (HRT), like most medical interventions, has risks as well as benefits. Here we dive into what HRT can and cannot do.
Let us first talk a little about what hormone replacement therapy (HRT) is. HRT is used primarily to help manage the symptoms of menopause: decreased bone density, hot flashes, fatigue, osteoporosis, night sweats, vaginal dryness, irritability, anxiety, insomnia, moodiness, and decreased libido. HRT involves replacing hormones – estrogen in particular and it is usually paired with progesterone unless you have had your uterus removed (hysterectomy). HRT can be delivered by oral medications, topical creams, patches, sprays, vaginal suppositories, or implants under the skin. Some of the side effects of HRT include increased risk of heart attack, blood clots, stroke, and breast cancer. These side effects depend on your age, health status, family history, and the type of hormone therapy prescribed.
HRT and menopause
Now that we have a bit of a foundation about hormone replacement therapy, let’s dive a little deeper into it.
Just to be clear: HRT cannot reverse menopause. Menopause is a normal part of healthy aging, so it is not something that we are trying to prevent indefinitely. HRT seeks to address menopausal symptoms when they are severe or are affecting your quality of life. For example, if hot flashes and insomnia are preventing deep sleep, this can disrupt your mood, weight, energy level, and even work performance and relationships. The recommendation when replacing hormones is to always use the lowest possible dose for the shortest amount of time to minimize risks and side effects. Do not be surprised if your doctor follows up with you frequently to assess your symptoms or changes the dose you are prescribed. So if you had visions of using HRT as a fountain of youth to keep feeling like you are 20 well into your 80s, perish the thought. That is not how HRT works.
The elephant in the room
There is always some big, scary detail that needs to be addressed. According to the Society for Endocrinology, all forms of HRT increase a woman’s risk for breast cancer and some forms increase risk of uterine cancer. There are many factors involved in understanding the risk. Mayo Clinic states that personal medical history, family history, and individual risk of cancer, blood clot, heart disease, stroke, osteoporosis and liver disease are all important factors to talk about with your doctor. The various forms of HRT carry different risks of side effects. It has also been found that women starting HRT after 60 years of age or more than 10 years after the onset of menopause are at a greater risk of adverse events like stroke, blood clot and breast cancer.
As with any medical decision, there is the need to weigh the risks and benefits. For many women who start HRT before 60 years old or within 10 years of menopause, the benefits outweigh the risks. Assessing the cost-benefit analysis must also include how severe a woman’s symptoms are. This is a conversation that must take place with your primary care provider so that they can assess your individual circumstances.
TMenopausal symptoms can be very disrupting to everyday life. Vaginal dryness and low libido may stress your connection with your partner or spouse. Fatigue and irritability may cause friction at work. Hot flashes may create embarrassment or decrease your desire for social interactions. Insomnia and night sweats may negatively impact your energy levels and overall well-being. But HRT is not the only way to manage menopause.
One of the easiest natural approaches for menopausal symptoms is seed cycling. I have an article coming on March 10th diving more deeply into this topic! It is a gentler way to mimic the natural cycles of estrogen and progesterone so be sure to check back for more information.
Seeking care from a qualified naturopathic doctor, integrative practitioner, holistic doctor or midwife can also help you find natural solutions. I have used herbs, homeopathic remedies, natural suppositories, adrenal support and diet/lifestyle counseling to help women successfully manage their menopausal symptoms. HRT is a good option for some women but you should not be afraid to explore options that carry a lower risk first. Medicine typically recommends starting with the least risky treatments first and proceeding with higher force interventions if necessary.
Remember, HRT is not the fountain of youth. It is a tool that can be beneficial but that also carries risks. If you are experiencing menopausal symptoms, be sure to speak to your primary care physician to understand all of your options.