Menopause and Hormone Replacement Therapy: The Benefits Outweigh the Risks

By Jennifer Engels, MD

For many years, hormone replacement therapy (HRT) was used to treat the symptoms of women going through menopause. Unfortunately, a large element of uncertainty was injected into the use of this therapy by the government-funded Women’s Health Initiative (WHI) in 2002. This study basically concluded that hormone replacement therapy using estrogen and progestin increased the risks for coronary heart disease, invasive breast cancer, stroke, and blood clots in the veins, a condition clinically known as venous thromboembolism that can lead to disability and death.

The publication of this 2002 study created much confusion and uncertainty among both physicians and patients about the efficacy and safety of HRT, and unfortunately, many patients lost out on the benefits of HRT. In the years since 2002, however, several additional investigations have challenged both the methodology and many of the conclusions of the WHI study. For example, a more recent study conducted under the auspices of the National Center for Biotechnology Information (NCBI) concluded that HRT using estrogen and progestin does not increase the risk of cardiovascular disease, invasive breast cancer, stroke or venous thromboembolism for post-menopausal women.

So, as the shortcomings and errors of the 2002 WHI study have become increasingly apparent, HRT has once again emerged as a widely accepted therapy used in easing many of the symptoms suffered by both pre- and post-menopausal women.

With all of this in mind, I want to briefly review the use of Bio-identical HRT (BHRT), beginning with a brief explanation of the effect that aging has on hormone levels. Hopefully, this discussion will help you decide if hormone replacement therapy is right for you.

Aging and your hormones

One of the easiest ways to understand hormones is to think of them as chemical messengers traveling through your blood to your body’s tissues and organs and regulating how your body functions. As we age, the reproductive hormones naturally wane, and while this change can affect men as well as women, in this article we’re focused on women. For women, bodily changes brought on by declining hormonal levels include:

• Loss of bone density
• Wrinkly or sagging skin
• Chronic fatigue
• Weight gain
• Hair loss
• Insomnia
• Night sweats
• Hot flashes
• Low libido
• Vaginal dryness and irritation
• Depression
• Anxiety, agitation and/or irritability

Types of hormone therapy

Bio-identical hormone replacement therapy primarily focuses on replacing estrogen, progesterone as well as testosterone depending on which if not all of these hormones are deficient in a peri menopausal or menopausal woman. Even if the woman has had her uterus removed, she could benefit from bio-identical estrogen and progesterone therapy. We have progesterone receptors on almost every cell in our body, so it is still important to replace progesterone in order to keep the estrogen/progesterone balance in check. There are multiple different options as far as delivery of these bio-identical hormones to the patient. The methods offered at WeCare Frisco include pellets, patches, creams, gels, or troches.​

Lifestyle choices and hormonal balance

In addition to BHRT, hormonal imbalances can also be addressed through lifestyle choices and changes. These include regular exercise, eating a healthy diet with an abundance of fresh fruits and vegetables, maintaining a healthy weight, not smoking, limiting alcohol consumption, managing stress, and controlling other health conditions such as high cholesterol and high blood pressure. There are also target nutraceuticals that can help enhance a patient’s own production and optimization of their intrinsic hormones.

A balanced approach at WeCare Frisco

At WeCare Frisco we’re here to help you deal with the symptoms and problems associated with hormonal imbalances. As a practitioner of functional medicine, I am a firm believer in using a variety of therapies to deal with this medical issue. I am also equally committed to encouraging a collaboration between patient and physician that promotes patient involvement in the healing process.

If you think you may benefit from hormone replacement therapy, I urge you to contact WeCare Frisco to schedule your initial consultation.