Hormone Replacement Therapy (HRT) – The HeaRT of the Matter

I was getting my hair done a couple years ago at my favorite salon, along with five other women ‘of an age’, when talk turned to the Change. Most of us were loudly proclaiming our favorite natural remedies and fixes. The woman in the chair adjacent to mine finally spoke up apologizing to the roomful of menopausal goddesses for having "caved", finally starting HRT (Hormone Replacement Therapy)..

"It’s just that I couldn’t sleep," she told us shamefacedly. "I couldn’t sleep at all. I was so tired I couldn’t function. And nothing else worked." We all leapt in to assure her that there was no need to feel guilty. The risk-benefit ratio seemed pretty clear to all of us. Underscored for us was that we women need to support one another through this process rather than judge anyone, including ourselves.

But I have to admit that I was feeling pretty smug and blessed that I was coping without HRT. My symptoms were manageable. What’s that thing they say goeth before a fall? Oh yeah, pride. I no longer have a surplus of that. I eventually ended up on low dose HRT myself. And honestly, I wish I’d taken it sooner.

First welcomed as a godsend, now seen as a terrifying, politically incorrect alternative for menopause symptom relief, HRT may actually be neither. In deciding whether we wish to consider HRT as a viable option, we really need to evaluate our personal risk-benefit analysis. In other words we need to list pros and cons, and then weigh those pros and cons in order of importance.

History of breast or other reproductive cancers in your family would cause you to rate your risk higher. Family history of blood clots, stroke, or heart disease also put you at higher risk. If you have or have had any of these conditions yourself, the risk may be too high and you’ll want to look elsewhere for help. And if you are a smoker? HRT is not a great idea for you; your risk of heart attack, stroke and other cardiovascular disease spikes.

On the benefit side, if your hot flashes are 30+ per day, so intense that you are nauseous, or your sleep deprivation from insomnia is making you psychotic, then HRT may be a valuable help in the short term. More risk is associated for all women with long term usage of HRT, so taking it to "get over the hump" may be an option. Above all, do not feel guilty if you decide that the herbal, natural route didn’t work for you and you need to avail yourself of HRT. Our own Beej-Venus tried herbs and immediately stopped using them because they "gave me a rush".

If you should decide to consider HRT as an alternative, be sure to stay aware and re-evaluate periodically whether you might be ready to slowly decrease and ultimately discontinue your hormones. Above all, be gentle with yourself and choose what’s right for you. (Next blog entry, we’ll examine briefly both bioidentical and synthetic hormones. Material partially adapted from our upcoming book -to be released very soon. We’ll keep you posted.)

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4 Responses to Hormone Replacement Therapy (HRT) – The HeaRT of the Matter

  1. Betty Zahler September 23, 2009 at 7:43 am #

    Menopause can be a problem but we know at times, need a bit of help. The HRT therapy is for those goddesses who are suffering and should not be a guilt factor for them. All sistahs be undaunted when help if needed!. Again Lynette, thank you for your help and understanding.

  2. Cynthia Sawtell September 23, 2009 at 7:43 am #

    Just another thing to consider… The unexpected results in the Women's Study that caused all of the brouhaha regarding HRT in the first place do NOT apply to every woman in every circumstance. It's important to note that the treatment causing the increase in cancer rates was a combination of Estrogen and Progesterone among women who had not undergone hysterectomies.

    This Menapausal Goddess had a hysterectomy at age 39 but was left with one ovary. I was taking estrogen alone to deal with my hot flashes. After the study results were made known, I chose to reduce the dosage to the lowest possible and switch to a bio-identical form of estrogen (Estradiol), supplementing with black cohosh. As there was no family history of breast or ovarian cancer, I'd breast-fed my babies, and had very low risk of cardio/vascular problems, my doctor and I agreed that this was a safe course of action for me.

    I stopped losing sleep over it (pun intended).

  3. moonseazen September 23, 2009 at 7:43 am #

    I was thrown into a total surgical menopause before any menopausal symptoms were apparent, and was not even initially prescribed any replacement at all. It was difficult.

    I did take some estrogen supplement for about 6 months, but other conditions intervened that made it risky. I spent a year feeling like I had totally lost my marbles. Then I did the Black Cohash, but alas, it had some unwanted side effects, so I stopped. I was "cold turkey" again for 1 1/2 years. Not good.

    It has been about 4 years since the surgery, and I am happy to say I am now relatively symptom free…(still aging though!)…so do believe that there is hope for all of you!

    However, I recently read a study that cited early onset-dementia in women who did not get replacement therapy within a short period after surgical menopause!

    You may want to research that, but no one should be ashamed to seek treatment. It is your body and your longevity and your life. Do what you need to do.

    It is too bad for women that these studies are new when this problem has persisted for eons. As if there isn't enough other stuff on our plates to make us crazy! Keep up the good work.


  1. Menopause Research Study On Hormone Therapy Cessation | Menopause Goddess Blog dot com - June 1, 2010

    […] you are a Menopause Goddess in the process of decreasing or discontinuing your HRT (hormone replacement therapy) or have already ceased your HRT, I urge you to contact Mary to participate in the study. I’ve […]

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