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The real risks of HRT

Hormone replacement therapy has been the subject of intense debate for over ten years. After the Women’s Health Initiative results were published in 2002, women and their doctors feared breast cancer, stroke and heart disease, and so what was once a mainstay for menopause treatment quickly became too risky.

Woman holding a prescription for hormone replacement therapy (HRT)

Women were immediately taken off of, or took themselves off of, hormone therapies like Premarin and Prempro, and left to suffer from rebound symptoms, with no true alternatives.

Now, physicians are coming back to prescribing hormone replacement therapy for some women. But what makes HRT safe for some women and not others? We’ve been keeping up with this debate over the years and following the research as well. Ultimately, the decision to take HRT is between a woman and her healthcare provider but the best way to prepare yourself to make that decision is by educating yourself first.

The Women’s Health Initiative — what we know now

The original results of the Women’s Health Initiative showed that women who took estrogen and progestin had increased risks for heart attack, stroke, blood clots, and breast cancer. For those who took estrogen alone, the results showed increased risk of stroke, blood clots, with an uncertain effect on breast cancer. These results made it clear that hormone replacement therapy came with significant risk.

The passage of time has given researchers more perspective on the original results. For instance, most of the women enrolled in the WHI were older and far beyond menopause. Newer studies are suggesting that women less than 60 years old and within ten years of menopause are at considerably less risk than older women, and, in fact, may benefit from hormone replacement therapy. Yet, the US Preventive Services Task Force published a report in 2012 concluding that the risks of hormone therapy still outweigh the benefits.

Do the risks outweigh the benefits for you?

Our stance on hormone replacement therapy is that the decision is personal and the risks and benefits should be discussed with your practitioner. However, based on the recent research, there are some guidelines you should consider as you make your decision. HRT risks go down if:

  • You are less than 60 years old.
  • You are close to menopause and still having symptoms.
  • Your personal and family medical history do NOT include breast cancer, endometrial cancer, ovarian cancer, or liver disease.
  • You use transdermal, transvaginal, sublingual, or melt forms of HRT instead of pills that are taken orally.
  • You don’t use hormone replacement therapy for more than five to seven years.

Each woman has a unique set of circumstances and should always make decisions about hormone therapy with her healthcare practitioner. If you are experiencing severe symptoms that are significantly impacting your life, HRT may be the best option for you. However, consider our recommendation to always begin with the least invasive approach first and add more support, if needed.

Phytotherapy — an effective alternative to HRT

Phytotherapy, the use of medicinal plants and plant extracts heal and restore balance in the body, is a great way to manage menopause symptoms without the risks of HRT. Several herbs have shown great results for women. We recommend black cohosh, kudzu, and red clover for symptoms of estrogen imbalance like hot flashes and night sweats. Passionflower, chasteberry, and wild yam work well for symptoms related to progesterone imbalance like anxiety, insomnia, and irritability.

We’ve found that the most effective approach to eliminating menopause symptoms includes a multi-botanical like our Herbal Equilibrium (which contains all the herbs above and ashwagandha for its mood stabilization and aphrodisiac properties), plus a high-quality multivitamin/mineral complex and hormone-friendly changes in diet and lifestyle. Our Hormonal Health Program includes all of this, plus phone support from women right here in Maine so you can personalize our approach to fit your needs for menopause relief. There are lots of options for frustrating menopause symptoms — and we are here to help!

Last Updated: January 12, 2022
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