Menopause Mondays: Is HRT a Trick or a Treat?

When you go through perimenopause and menopause (I call it PM&M for short!), your body begins to produce different—usually lower—amounts of estrogen, progesterone and/or testosterone hormones. These fluctuations often result in less-than-thrilling symptoms, such as weight gain, sleepless nights, hot flashes, night sweats, irritability, depression and memory loss, just to name a few (sounds fun, right?). HRT* (hormone replacement therapy) is intended to supplement hormonal production and therefore moderate these fluctuations, ultimately providing an umbrella for women caught in the PM&M storm.

There are so many confusing terms and studies out there that delving into HRT can be just plain spooky! The big question: HRT—Is it a trick or a treat?

You may have heard the words natural, synthetic and bioidentical tossed around in discussions of HRT. Buyer beware: not all HRT options are created equal. One important distinction is whether a hormone therapy supplement is bioidentical or not. A bioidentical hormone is chemically identical to the hormone produced in your body. It may have come from a natural substance that’s been synthesized in a lab, but the important distinction is that it has the same chemical structure as what your body makes. Case in point, the hormones that the WHI 2002 (Women’s Health Initiative) studied were synthetic hormones which were not bioidentical—Premrin, derived from pregnant mare’s urine, and Provera, a synthetic progestin. It seems logical to me that a hormone that is meant for a 1500-pound horse might be too much for my body. Even on a bad day, when I look in the mirror and think I am huge, I know I don’t weigh 1500 pounds! It wasn’t until the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial that we began to compare synthetic progestins to natural progesterone such as Prometrium or progesterone cream.

It’s important to understand that your body reacts differently to all these different therapies. When you engage in bioidentical hormone therapy, your body may react the same way it would if it produced the hormone itself, because chemically speaking, they are the identical. When you take hormone therapy that is not bioidentical, your body may react differently, and in some cases, this might not be as helpful or beneficial as the bioidentical options.

Don’t be fooled by a hormone with two names. Even if one of those names is the name of your body’s hormone, the presence of another name should tip you off that you are NOT dealing with a bioidentical hormone. For example, estradiol is bioidentical, but ethinyl estradiol is not. Don’t fret, it’s easy to check and see if your HRT is bioidentical. Check out the hormone brand chart in Shmirshky: the pursuit of hormone happiness, pages 156-160.

Keep in mind that all women are different (and pretty darn fabulous, if you ask me). Each shmirshky has unique challenges that require different solutions. Regardless of your own particular situation, there are many schools of thought on hormone therapy, and it is up to you to educate yourself and, together with your PM&M specialist, draw your own conclusions about what is best for your body. Discuss the risks and benefits related to heart disease, artery disease, osteoporosis and cancer. Definitely include a conversation about the physical and emotional benefits that pertain to your particular needs.

Arm yourself with knowledge. You may want to begin by reading some recent news about the risk-benefit analysis of HRT, which focuses on individualizing hormone therapy to help reduce health risks. Also, take a minute to read this blog if you’re considering discontinuing HRT.

There have been recent studies that shed light on side effects and benefits that vary by age, including the effects of HRT on heart disease, HRT effects on women who have undergone hysterectomies, and the most recent news on the effectiveness of alternative treatments for those wary of HRT.

These articles prove there is no one-size-fits-all scenario (although there are some one-size-fits-all elastic-waist pants you might want to check out!).

Don’t be disheartened by all the studies out there with conflicting information.  However confusing and frustrating it may be, keep reading and educating yourself. Then, with a PM&M specialist, you can figure out which course of action is best for you.

Depending on your medical history, your options may vary. A good starting point is to ask yourself, “On a scale of 1 to 10, how am I functioning?” Some women are so used to being less than fully-functioning that they accept functioning at a 2. You don’t have to settle! Once you are aware of your challenges, you can begin to find the right solutions. Whatever you do, don’t give up trying to be as close to a 10 as possible. Think Bo Derek for menopause!

This may all seem very tricky, but keep searching for the solutions that are right for you. Treat yourself to wellness and happiness. You deserve it!

Reaching out is IN. Suffering in silence is OUT!

*Also called HT (hormone therapy or hormone treatment).