Working with women’s hormones day in day out, I get asked a lot about HRT and in particular about HRT safety. Now I am not a medical doctor, but it's my job to know a lot about hormones and treatment options. And make sense of the latest research so that I can educate and empower women to make informed choices.
Many people assume that just because I teach women how to manage their menopause naturally, that I’m anti-HRT. And I do know a few people on that side of the argument.
But things are never that simple are they? Nothing is black or white and there’s no one size fits all, especially when it comes to women's hormones! I am not anti HRT or any medical treatments that work. What I am FOR, is choice. Informed, personal choice is what every woman deserves.
The importance of diet and lifestyle
Most women can get relief from menopausal symptoms just by changing their diet and lifestyle, and taking some targeted supplements. However, every woman is unique and while diet and lifestyle can make a huge difference, replacing sex hormone levels may be the only option for some. And vital if you have had an early menopause or a surgically induced menopause (partial or full hysterectomy or oophorectomy).
What you need to know about HRT
There are 2 main things I want women to be aware of when choosing to take HRT;
1/ Menopause is not just about oestrogen and progesterone. These are 2 hormones that can cause symptoms, but we have a hundred or so other hormones that can also suffer during this time. HRT will only help with 2! And if the others are out of balance, you’ll need to sort those out
2/ Is it safe? Not all HRT is created equal. The links between HRT and increased risk of breast cancer have ONLY shown so far to apply to combined synthetic oestrogen/progestin, taken orally. There is no evidence that I’m aware of that shows any additional risks if you take body identical oestrogen and progesterone (patch, gel, Uterogestan, vaginal applications).
What are Body or Bio Identical Hormones?
The terms Body Identical and Bio Identical are one and the same thing. NHS doctors know them as Body Identical, and more and more doctors are switching to this type of hormone replacement. These brands are still made in the lab, but are chemically identical to your own hormones. They are obtained primarily from plants (soya beans and wild yams), and pharmaceutically transformed to human body-identical hormones. Oestrogen is usually given as a patch, gel or vaginal cream, progesterone in micronized format (oral or pessaries). Here's an explanation of the different types from Dr Renee Hoenderkamp.
Bio-identical hormones from private doctors and clinics have been criticized by some medical professionals as unsafe and unproven as the compounding pharmacies that produce them are not widely regulated. However, they have become popular as many GP’s are still reluctant to prescribe body-identical HRT, they include testosterone and DHEA (not available currently on the NHS) and they are made to order for your exact dose by the compounding pharmacy.
Are they safe? All hormones are delicately balanced, so even with bio-identical HRT, an excess or deficiency in one or more can result in adverse symptoms or increased risk of a hormone-related disease.
Is HRT right for you?
Every woman is different. I know women who thrive on HRT, while many who don’t want to or can’t take hormones, or are worried about HRT safety, have managed to deal with their symptoms without any prescriptions at all. The most important thing is that you take responsibility for your own health and make sure you’re fully informed:
- Do your own research and always get a second opinion.
- If your doctor is not helpful and won't offer you body identical hormones, find a new one!
- Or work with a qualified health professional who can support you and advise you on your options
- Get tested – tests can show your hormone levels, how efficiently you are metabolizing and detoxifying your hormones and whether there are any other health risks or genetic factors that could affect your treatment. There are many factors that can upset your hormone balance, and they all need to be considered before embarking on any hormone replacement therapy.
A woman’s life expectancy in the 21st century in the western world is now over 80 (according to the World Health Organization). The average age of menopause is 51. That means that we will be living potentially for 30 years in post-menopause so it’s important to make sure those years are the best they can be!
Do contact us if you'd like any further information on managing your menopause naturally, HRT safety or getting your hormones tested.