Team Inspiriko - May 2023
Hormone Replacement Therapy: A Look at the Pros and Cons of HRT
Hormone Replacement Therapy, or HRT, is many times depicted as the savior of menopausal women, but is that so? You see, hormones are like little messengers, whispering instructions to different parts of our body: They play a crucial role in regulating our moods, body temperature, metabolism, and even our energy levels.
But here's the problem: as you gracefully glide through perimenopause, your hormone levels can waltz out of sync and bring about a myriad of symptoms that disrupt your life. This is when HRT can help, alleviating symptoms like hot flashes, night sweats, mood swings, and the occasional craving for ice cream at 2 a.m. In this article, we’ll weigh the pros and cons of HRT and how it can help you recover health and wellness during menopause. Shall we?
What is Hormone Replacement Therapy (HRT)?
Hormone Replacement Therapy, or HRT, is a treatment that is often used to alleviate the symptoms of menopause, which can be a difficult and uncomfortable experience. From mood swings to hot flashes and insomnia, menopause brings about many symptoms that can make your life a living hell, and this is where HRT comes in.
There are two main types of HRT: bioidentical HRT and body-identical HRT:
● Bioidentical HRT uses hormones that are identical in structure to the ones that are naturally produced by your body. These hormones are derived from plant sources such as yams and soybeans, and they are specially compounded by a pharmacist to meet the needs of each patient.
● Body-identical HRT, on the other hand, uses hormones that are synthesized in a laboratory and are not identical in structure to natural hormones.
HRT works by replacing the female hormones that your body is no longer producing, which can help to alleviate the symptoms of menopause, such as hot flashes, night sweats, vaginal dryness, mood swings, and sleep disturbances, among others. HRT can be administered in several different ways, such as creams, pills, or even injections. If you are considering HRT, be sure to discuss the risks and benefits with your healthcare provider to determine if it is the right choice for you.
Pros of HRT
● Reduced risk of osteoporosis. As you age, your body naturally loses bone density, and this can lead to an increased risk of fractures and other bone-related injuries. This is triggered by the decline of estrogen in your body. However, HRT can help to slow down this process and maintain bone density, reducing the risk of osteoporosis and related complications (1).
● Improved mood and quality of life. Menopause can be a difficult and uncomfortable experience, and many women experience symptoms such as anxiety, depression, and mood swings. HRT can re-balance your hormones and help alleviate these symptoms, leading to an improved overall mood and a better quality of life (2).
● Relief of hot flashes and other menopause symptoms. And let’s not forget that hot flashes can be particularly distressing, as they can interfere with daily activities and sleep. Women with HRT report a reduction in the frequency and severity of hot flashes (3).
● Potential cardiovascular benefits. Women who undergo HRT may have a lower risk of heart disease and stroke, as the hormones used in HRT can help to reduce inflammation and improve cholesterol levels (4).
Cons of HRT
While HRT can offer benefits during menopause, it is not without potential risks and drawbacks.
● Studies have shown that long-term use of HRT increases the risk of breast cancer and the risk is particularly higher in women who take a combination of estrogen and progestin, though the reason behind it is not entirely understood (5).
● Another potential risk is an increased risk of heart disease. While HRT may have cardiovascular benefits in some women, it is important to note that this is not true for everyone. Some studies have suggested that some forms of HRT may increase the risk of blood clots in the case of people with pre-existing cardiovascular risk factors (6).
● Also, some healthcare providers may be hesitant to prescribe HRT due to concerns about the risks, and women may struggle to find a provider who is willing to prescribe the treatment.
● And women who undergo HRT should receive regular check-ups to ensure that the treatment is working as intended and to monitor for any potential side effects or complications.
Alternatives to HRT
If you’re concerned about the risks or if your doctor has determined HRT is not for you, don’t be discouraged. There are many alternatives to HRT to manage menopause symptoms, such as the ones we’re mentioning below:
Exercise
Regular physical activity is an effective way to manage certain menopause symptoms and improve overall health and well-being. Some examples include:
● Reduction of hot flashes. Studies have shown that regular moderate exercise, such as brisk walking or cycling, can help to reduce the frequency and severity of hot flashes by regulating and lowering your temperature (7).
● Mood & sleep improvement. Exercise can also improve mood by releasing endorphins, which are natural mood-boosting chemicals in the brain (8). Additionally, regular exercise has been shown to improve sleep quality, which can be an issue for many women experiencing menopause.
● Preventing weight gain. During menopause, many women experience changes in their body composition, including weight gain and redistribution of fat. This is commonly seen around the abdomen and waist, which can increase the risk of certain health conditions such as cardiovascular disease and type 2 diabetes (8). This is when regular exercise can come to the rescue and play a crucial role in managing weight gain. First, it increases energy expenditure, helping to create a calorie deficit and promoting weight loss. Additionally, resistance or strength training exercises help build and maintain muscle mass, boosting metabolism and helping you maintain a healthy weight.
To reap the benefits of exercise, it is recommended to aim for at least 30 minutes of moderate exercise on most days of the week, including brisk walking, cycling, swimming, or dancing. Strength training exercises, such as lifting weights or doing bodyweight exercises, can also be beneficial for improving bone density and preventing osteoporosis, which is another common issue for women during menopause.
Dietary changes
A healthy diet can play a significant role in managing menopause symptoms and supporting overall well-being during this stage of life. In addition to providing you with nutrients while avoiding excessive calorie intake, eating a healthy diet rich in calcium and vitamin D is essential to support bone strength and help you prevent osteoporosis.
Also, certain foods and beverages can trigger or worsen hot flashes and night sweats, such as caffeine, alcohol, spicy foods, and sugary foods. Focus on incorporating plenty of fruits and vegetables, whole grains, and lean protein. One of the most effective diets for women during menopause is the Mediterranean diet.
Certain supplements may also be helpful for managing menopause symptoms. For example, black cohosh has been shown to reduce hot flashes, similar to red maca root. Others that may be useful with menopause symptoms include red clover, evening primrose oil, and vitamin E, so why not try out our natural supplement Thrive Not Pause, which can help re-balance your hormones and do away with menopause symptoms?
Mind-body Techniques
For a healthy body, you’ll also need a healthy mind. Today, mind-body techniques such as yoga, meditation, and deep breathing are increasingly popular as a complementary therapy for women experiencing menopause symptoms. These techniques work by engaging the mind and body in ways that promote relaxation, reduce stress, and improve overall well-being.
Yoga, for example, is a form of exercise that incorporates physical postures, breathing exercises, and meditation. Research has shown that regular yoga practice can help to reduce hot flashes, improve sleep, and reduce anxiety, so why not give it a try?
Acupuncture
Ever heard about acupuncture as a way to manage menopause symptoms? This is a traditional Chinese medicine technique where an expert will introduce very small needles into strategic parts of your body. Yes, it may sound scary, but studies have shown that acupuncture can be an effective alternative to HRT for reducing hot flashes and night sweats (10).
The exact mechanism by which acupuncture works is not yet fully understood, but it is thought to stimulate the body's natural healing processes and help to balance hormones. The process is generally painless, and you will probably find it to be a relaxing and enjoyable experience!
Redefining Wellness Through HRT
All in all, HRT remains a complex and controversial topic in menopause management. Throughout this article, we have explored the pros and cons of HRT, recognizing its potential benefits in alleviating menopausal symptoms and reducing the risk of certain conditions such as osteoporosis.
However, we must also acknowledge the potential risks associated with HRT, including an increased risk of certain cancers and cardiovascular events. As a key takeaway, we want to highlight the importance of individualized decision-making when it comes to HRT: together with your healthcare provider, you’ll be able to consider all the available options and weigh the potential benefits and risks of HRT on your health.
REFERENCES
1. Gambacciani, M., & Levancini, M. (2014). Featured Editorial Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Menopausal Review, 4, 213–220. https://doi.org/10.5114/pm.2014.44996
2. Fait, T. (2019). Menopause hormone therapy: latest developments and clinical practice. Drugs in Context, 8, 1–9. https://doi.org/10.7573/dic.212551
3. Gallicchio, L., Whiteman, M. K., Tomic, D., Miller, K. P., Langenberg, P., & Flaws, J. A. (2006). Type of menopause, patterns of hormone therapy use, and hot flashes. Fertility and Sterility, 85(5), 1432–1440. https://doi.org/10.1016/j.fertnstert.2005.10.033
4. van der Mooren, M. J., Mijatovic, V., Marchien van Baal, W., & Stehouwer, C. D. A. (1998). Hormone replacement therapy in postmenopausal women with specific risk factors for coronary artery disease. Maturitas, 30(1), 27–36. https://doi.org/10.1016/s0378-5122(98)00056-5
5. Does hormone replacement therapy (HRT) increase the risk of cancer? (n.d.). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/does-hormone-replacement-therapy-increase-cancer-risk#:~:text=Breast%20cancer:%20oestrogen-only%20HRT,longer%20that%20HRT%20was%20used
6. Menopause and heart disease. (n.d.). British Heart Foundation. https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease
7. Romani, W. A., Gallicchio, L., & Flaws, J. A. (2009). The association between physical activity and hot flash severity, frequency, and duration in mid-life women. American Journal of Human Biology, 21(1), 127–129. https://doi.org/10.1002/ajhb.20834
8. Exercising for Better Sleep. (n.d.). Johns Hopkins Medicine, based in Baltimore, Maryland. https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercising-for-better-sleep#:~:text=Aerobic%20exercise%20causes%20the%20body,wind%20down,”%20she%20says.
9. Chapple, Bridget. (2022, October 13). Menopause and diabetes. Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/menopause#:~:text=The%20perimenopause%20and%20the%20menopause%20don't%20cause%20diabetes.,also%20include%20age%20and%20ethnicity.
10. Lee, M. S., Kim, K.-H., Choi, S.-M., & Ernst, E. (2008). Acupuncture for treating hot flashes in breast cancer patients: a systematic review. Breast Cancer Research and Treatment, 115(3), 497–503. https://doi.org/10.1007/s10549-008-0230-z
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