After menopause, the body no longer produces follicle stimulating hormone (FSH) and luteinizing hormone (LH), which tell the ovaries to produce progesterone, estrogen, and estradiol.  These hormones are still produced by other parts of the body but in insufficient quantities. The body is not used to the lack of hormones and familiar symptoms such as hot flashes, osteoporosis, and fatigue

Hormone Replacement Therapy

One way to relieve the symptoms of menopause is to give the body the hormones that are deficient. This is called hormone replacement therapy. The hormones used for this treatment are either the actual missing hormones (hormone replacement therapy) or similar hormones (Bioidentical Hormone Replacement Theme).

The problem is that with traditional (pharmaceutical) hormone replacement therapy is that the drugs used are very potent and end up causing cancer with prolonged usage.

HRT risks and possible side effects include:

  • Increased risk of endometrial cancer in women with a uterus if estrogen is taken without progesterone or a progestin
  • Slightly increased risk of breast cancer after 4 or more years of HRT, as shown in the WHI study that used continuous combined oral estrogen and progestin (Prempro). Estrogen alone or other HRT regimens may not raise the risk of breast cancer significantly.
  • Increased breast density, making mammograms more difficult to interpret and possibly increasing breast cancer risk. This appears to be an effect primarily associated with taking oral progestin continuously with estrogen (e.g., Prempro).
  • Slightly increased risk of ovarian cancer
  • Slightly increased risk of blood clots, associated primarily with oral estrogens such as Premarin*
  • Increased risk of gallbladder disease, associated primarily with oral estrogens such as Premarin*
  • Slightly increased risk of heart attack or stroke, both in women with cardiovascular disease and in healthy women. This effect may be associated primarily with HRT using continuous combined oral estrogen and progestin (Prempro) or the daily use of an oral progestin such as Provera with estrogen.
  • Breast pain (often a temporary problem)
  • Nausea, associated primarily with oral estrogens*
  • Bloating and fluid retention, primarily associated with progestins, e.g., medroxyprogesterone acetate
  • Negative effects on mood, primarily associated with progestins, e.g., medroxyprogesterone acetate

*Note: These side effects seem to be associated with oral estrogen and not with transdermal estrogen.

HRT is usually not recommended for women who have:

  • Vaginal bleeding for no known reason
  • A history of breast cancer
  • A history of cancer of the uterus
  • Liver disease
  • Blood clots in the veins or legs, or in the lungs. This includes women who have had blood clots during pregnancy or when taking birth control pills.
  • Cardiovascular disease (diseases of the heart and blood vessels)

There are alternatives to prescription hormone replacement therapy which include progesterone/estrogen/estriol creams and herbal supplements.  These products aren’t as powerful as the products used in hormone replacement therapy but they do provide relief from menopause symptoms. The best products contain BOTH progesterone and estrogen because those are the hormones that are missing when menopause hits.

There are risks involved in supplementing your body with hormones and these risks increase dramatically with traditional hormone replacement therapy because of the strength of pharmaceutical products. Natural creams and supplements contain phytoestrogens which are plant-based estrogens that mimic but are not exact copies of the body’s own hormones