Hormone Replacement Therapy for Menopause

Pull up a chair. It’s time for a story. Back in the ’90s and early 2000s, a single study by the Women’s Health Initiative disrupted years of progress in the field of hormone replacement therapy (HRT) for menopause. The study’s flawed claims made many physicians and women alike reject the healing power of HRT, and it has taken years for this quality of life-saving medicine to bounce back – but we’re here to tell you that done right, HRT can make a major difference in the way you experience perimenopause. Here’s how. 

Hormones As You Age 

Here’s a general rule of health for you: your body is always trying to maintain a healthy balance. Throw one thing off, and its #1 priority is to counteract the effects and return you to homeostasis. So when you enter into perimenopause, and your endocrine function and ovarian production begin to taper off, your body responds with varying levels of hormones that can interrupt your daily routine.

And that’s when the dreaded perimenopause symptoms set in. 

Hot flashes. Mood swings. Bone density loss. Increased cholesterol.  All of these experiences are part of the natural aging process. But as key players like estrogen and progesterone take turns sitting out of the game and hogging the ball, so to speak, the hormone fluctuations can feel like an emotional and biological rollercoaster. And that’s where hormone replacement therapy comes in. 

How Hormone Replacement Therapy Works

Everyone wants to age as gracefully as Audrey Hepburn, but we’d also be kidding ourselves if we didn’t all hope we looked like J-Lo at 54. While fillers and Botox might work well to mitigate the appearance of growing older, hormone replacement therapy (HRT) addresses the root cause: replenishing lost hormones. 

And this approach can get you a lot closer to following in your aging idols’ footsteps. 

The Process

Every treatment starts somewhere, and developing a solid foundation for your HRT journey is the first step. To begin, your doctor will test your hormone levels to determine your baseline for treatment. This panel might come from a number of tests, including urine samples, blood labs, or even saliva tests. 

Once your doctor has established your current hormone levels, they can prescribe a treatment that brings your hormones back to a healthy, stable balance. At this stage, there are two considerations that affect the type of treatment your doctor opts for: dose and form. 

Depending on your hormone levels, your doctor may adjust the amount of hormone supplements you receive – but they’ll also prescribe a method of administration. You could get HRT through pills, patches, gels, creams, vaginal rings, or pellets. The important thing is this: that your doctor prescribes you the individualized treatment dose and form that works best for your body. This could take time to decipher, which is why working with your doctor over the long term can improve your results. 

HRT Done Wrong

Here’s the thing. Like with many women’s health issues, unfortunately, the research is still catching up with reality. Not every doctor is up to speed on the best methods of treatment. Doctors could fail to provide the right HRT supplements by missing the mark when prescribing the dose and form. And the worst part of all is that some of the resulting side effects could be irreversible. 

Getting the Wrong Dosage

Most HRT treatments for menopause rely on standard, fixed hormone concentrations, which may work for some women but not all. Think of it this way: if Patient A starts at 50% of the appropriate hormone volume and Patient B starts at 30%, adding a 50% supplement to both only balances Patient A’s hormones. The other still isn’t getting what she needs. On the other hand, giving both patients 70% could bring Patient A to a surplus of 120% – and that’s not helpful either. 

Getting too much or too little of your regimen could have risky side effects ranging from inadequate symptom relief on one end to weight gain, excessive anger, bleeding, or even oddly placed hair growth on the other. 

Getting the Wrong Form

Different forms of hormone supplements have varying absorption rates. For example, oral pills have different effects compared to patches because the pill must be digested and passed through the liver. Other concerns include compliance (if you’re likely to forget to take a daily pill, would a weekly patch work better?) and health risks (oral estrogen is associated with a higher risk of blood clots, for example). Pellets are implanted and release drug over time; but if the dose is implanted is too high, you can’t take it out! 

(You can tell we aren’t big fans of oral estrogen or pellet HRT). 

Hormone Replacement Therapy for Menopause

HRT Done Right: The Keys to Effective Treatment

Now that you’re properly scared of the risks, we’re here to help. There are specific and actionable ways that you and your doctor can approach hormone therapy without adding permanent unnatural hair growth or the like to your perimenopause checklist. Here’s what you need to know. 

Get Tested

Addressing deficiencies is impossible if you don’t know they exist. Knowledge is power, and knowing the status of your hormone levels can empower you and your doctor to get the right treatment for your needs. 

Start at the Right Time

As with most medical interventions, timing is critical to your treatment’s success. Delaying therapy can reduce treatment effectiveness and increase the risk of certain side effects, so we recommend visiting a hormone specialist at the onset of any menopausal symptoms (or, talk to your doctor around the age of menopause, the average age being 52 in the United states). 

Opt for Bioidentical Hormones

There are two hormone types: synthetic and bioidentical. Synthetic hormones don’t click with your body’s hormone receptors quite like bioidentical hormones do. That’s because bioidentical hormones are chemically identical to the hormones your body naturally produces, making them a safer and more natural alternative to their synthetic counterparts. Stick with bioidentical, and you’re on the right track. 

Prioritize Routine Monitoring 

Hormones fluctuate. As they change, you and your doctor should work together to balance your hormone levels with the appropriate medications – and this requires routine monitoring and adjustments. Be sure your doctor schedules regular visits to maintain your success.  Monitoring symptoms is important, but there are other targets for monitoring (like bone protection) that may require some objective measurements.  Also, monitoring is important for proper clearance or metabolism of hormones.  More on this subject later, but if you aren’t clearing hormones properly, you can actually increase risk for inflammatory conditions and other illnesses, including but not limited to breast cancer.  

Go for a Specialized Approach

Everybody is different, and so is every body. You deserve a treatment plan that addresses your unique hormone imbalances and adjusts with you as changes occur.  If the provider that is prescribing your hormones is not personalizing your treatment, monitoring your unique targets, or checking for proper clearance or metabolism, you may not be getting the most comprehensive treatment.  Salivary testing and urine metabolite testing can offer a glimpse into the hormone safety profile.   And, while standard concentrations exist, we can also compound your treatment to give you the exact right dose for your needs. 

Hormone Replacement Therapy for Menopause

Age Gracefully with HRT 

Perimenopause can be a difficult time, but relief is out there. Working with a specialist like ZüpMed’s own Dr. Emily Yopp can improve your symptom management and help you age gracefully – just like Audrey Hepburn (well, maybe not just like her, but you get the idea). For more information about how you can get started on your own HRT treatment for menopause, call us to schedule your hormone consultation.