Menopause and hormone replacement therapy are hot topics in the news these days. As Gen X approaches menopause we’re questioning everything about the experience.

We are realizing that we don’t have to suffer like our mothers, with endless hot flashes, weight gain and mood swings. We’ve invested too much time and energy into who we are to let is all slip away. We are certain there are options for staying healthy as we age.

The news is revealing that our best option is hormone replacement therapy. Study after study is showing that it’s safe and effective and necessary for quality of life as we age. Yet our generation is terrified of HRT.

Hundreds of doctors, nutritionists, specialists and influencers are currently weighing in on the “right” way to deal with menopause. Many of them are women, in their 50s and 60s who are leading the charge on research and treatment. They echo the claims of each other. Based on their practical experience as doctors and personal experiences of menopause.

At times, however, their advice can be conflicting, making it confusing to decipher what is true or what will work for you. My goal here is to present you with some of your options as well as the risks and benefits of each. 

Hormone Replacement Therapy (HRT)

Hormone replacement therapy has been around since the 1940s. Nearly 30 million prescriptions were being written, per year, for HRT by the early 1970s. By 1995 approximately 15 million women per year were taking it.

Until 2002 when the Women’s Health Initiative Study was released. It reported that estrogen increased the risk of breast cancer. Immediately women across the country threw their hormones in the trash.

The next two generations swore they’d never take it for menopause. It didn’t matter what health problems we faced or how few treatment options were available, HRT was a no. As a result, today only 27% of women receive treatment for their menopausal symptoms. Approximately 2.5 million, out of 10.5 million women over 50, are taking HRT.

A recent Washing Post article lays out the flaws of the study and makes the case for using HRT.

The organization stands by its work over 20 years later. Despite the numerous criticisms of its methodology and interpretation of the results. Some doctors even claim that not taking HRT can increase your risk of getting numerous cancers.

The book Estrogen Matters is a good place to start learning about the benefits and risks of estrogen therapy. It makes the case for the necessity of Estrogen as it applies to our long term health. It claims that many of the studies associating breast cancer with Estrogen are misleading.

HRT has improved greatly over the last few decades. The Food and Drug administration has taken several types of hormones off the market over the years. This has greatly lowered the risks associated with HRT.

Delivery methods and types of hormones used have become safer. It has, however, also created a maze of options that can lead to another path of confusion. The best way to approach this process is to identify what exactly you need, right now.

Types of Hormones used in Replacement Therapy (HRT) 

Estrogen

Our bodies make three types of estrogen:

• Estrone (E1) is the primary form of estrogen that your body makes after menopause.
• Estradiol (E2) is the primary form of estrogen in your body during your reproductive years. This is the most potent form of estrogen.
• Estriol (E3) is the primary form of estrogen during pregnancy.

Estradiol is the most commonly prescribed type of estrogen. Variations of this hormone are derived from both plant and equine urine.

Once our menstrual cycle ends the body slows down on the amount of estrogen it makes. Replacing estrogen in the body will help to mitigate symptoms like heart palpitations, fear of driving and high cholesterol.

Currently prescribed in the United States and delivered by cream, patch, injection or gel:

Premarin is a form of estrogen derived from pregnant horses urine.

Estradiol is a form of estrogen derived from yams.

Estratab, from what I could find is also plant and horse urine derived and is available in pill form.

The estrogen replacement will pack the biggest punch to your symptoms and give you the most relief of any other hormones. 

Progesterone

Micronized progesterone is plant derived and the safest known form for delivery. Progesterone replacement is a highly effective sleep and mood aid.

However, there are cases where women have had serious reactions to the most common form, Prometrium.

From nausea to suicidal thoughts, the effects can be quite bad. If you experience any of these reactions, call your doctor immediately. You have a few options for taking progesterone that won’t create the severe symptoms of Prometrium. 

The Mirena Ring is a device that is implanted in the uterus, similar to an IUD. It bypasses the stomach and is instead, absorbed directly into the uterus.

Testosterone

Muscle tone, energy, confidence and great hair are some of the gifts of this hormone. It can be hard to get it prescribed by a traditional doctor or covered by insurance. You may need to look outside your medical network if you think this may be a good solution for you.

Excess Testosterone can turn into a weak form of estrogen and throw off your Estrogen levels on a blood test. It can also help spike cortisol levels, which can create anxiety and weight gain. Use with caution only after all you other hormone levels are worked out with your doctor.

Non Hormonal Options 

There can be numerous reasons why you may choose to not take HRT at all. If you have a medical history of cancer or its in your family, you may want to find other alternatives. Although there are doctors who specialize in menopause that say estrogen does not play a high risk role in breast cancer. Do your research and talk with your doctor to determine what works best for you. 

Other reasons for not wanting to take HRT are: 

– Negative reactions to the medications

– Prefer to use food and supplements to tame your symptoms

– Personal beliefs about your body and its transition are to let it happen naturally

These are all acceptable ways to experience  the menopause transition.

 Options for prescribed, non-hormonal treatments

Veozah A recent innovation, FDA approved for hot flashes and night sweats

Brisdelle  An SSRI or antidepressant, also prescribed for hot flashes

Oxybutynin  For incontinence and overactive bladder

 Options for OTC, non-hormonal treatments

Equelle and Bonafide Proprietary supplements to mitigate symptoms

Black Cohosh and Wild Yam are easy to purchase online or at a health food store and are generally safe to use.

Whatever your reasons, it is totally valid to choose not to use HRT. However, you must do something to support your body during this transition.

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Disclosure:  This post contains affiliate links, meaning I get a commission if you decide to make a purchase through my links, at no cost to you.