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Menopause—that baggy, awkward term—can stir so much confusion and vulnerability which makes it especially hard to talk about. More than two decades ago, the shocking results of a major women’s health study challenged the safety of menopause hormones, and overnight, millions of women and their doctors abandoned the drugs. There’s still a residue of reluctance regarding hormone therapy that lingers today.
Menopause has been plagued with a terrible PR campaign. Many people identify menopause solely with
hot flashes and night sweats. However, menopause has subtle symptoms as well, such as depression and osteoporosis and low libido and pain with sex.
In an ideal world, more gynecologists, internists and urologists would run through a list of
hormonal symptoms with their middle-aged patients, rather than waiting to see if those women have the knowledge and wherewithal to bring them up on their own. But the fact is that for many of menopause’s most debilitating symptoms, there’s an established and effective protocol. So why aren’t more women offered it?
My menopause story: A personal awakening
This hits close to home. At 55, I spoke with my doctor about how menopause was affecting me. I said I had never experienced serious symptoms, neither hot flashes, nor serious brain fog or depression. My doctor responded that if there were no presenting symptoms, no treatment was necessary. The next year I returned. I had heard through the grapevine how wonderful some of my friends were feeling on hormone replacement therapy (HRT) and I wanted a piece of the action.
My doctor’s feelings on HRT had changed in the meanwhile too. “These days,” she said, “we are prescribing hormones more liberally, since they seem to be so helpful for so many things.” HRT can address brain fog, energy, sleep, joint pain, bone health, libido, and even small but impactful weight loss, that stuck two pounds around your middle that nothing seems to budge. I was eager to try HRT and curious about why I had held off on for as long as I had.
Lo and behold, I did start feeling better. I had more energy, more vitality, better sleep, less ache in my knee, more spring in my step. It was my middle-aged glow-up. Anecdotally, it supports the growing body of HRT research which is now known to be far more nuanced and reassuring. Many patients are still suspicious of hormones because they’ve heard that hormones are dangerous. There’s lots of clarifying that needs to happen.
The science of HRT: Separating fact from fiction
Although menopausal hormone therapy is far from obscure, it does tend to be overlooked or relegated as a treatment only for significant symptoms. HRT is known to relieve hot flashes, sleep disturbances, depression and joint pain. It also reduces the risk of diabetes, protects against osteoporosis, and addresses menopausal genitourinary syndrome—a group of symptoms like urinary tract infections and painful intercourse that affects nearly half of postmenopausal women.
Once a widely prescribed treatment in the U.S., with around 15 million women using it annually in the late 1990s,
hormone therapy saw a dramatic decline after a 2002 study reported potential health risks. The study, though flawed, led to widespread fear, and prescriptions plummeted within a year. While hormone therapy does carry risks, extensive research since 2002 has shown that for healthy women under 60 with severe symptoms, the benefits generally outweigh the risks. Despite this, the treatment’s reputation has not fully recovered, leading to decades of unnecessary suffering: disrupted sleep, missed opportunities at work, dampened daily joy, and countless other challenges.
Today, more advanced formulations more closely mimic natural hormones, and newer delivery methods, such as transdermal patches, reduce certain risks, like blood clots, by bypassing the liver. However, while promising, these newer options are primarily supported by observational studies rather than long-term, randomized trials.
Hormone Replacement Therapy (HRT) is sometimes described as a “fountain of youth” for its ability to address aging-related hormonal declines, particularly during menopause or andropause. But before you jump on the HRT bandwagon, it’s important to weigh your individual risks with your healthcare provider.
Potential benefits of HRT
Improved skin elasticity
Estrogen plays a critical role in maintaining skin thickness, elasticity, and hydration. Declining estrogen levels can lead to dryness and wrinkles, but HRT may slow these changes.
More spring in your step
Balanced hormones can reduce fatigue and improve energy levels, helping you feel more vibrant.
Stronger bones
Estrogen helps maintain bone density. HRT can reduce the risk of osteoporosis, a condition that can lead to frailty and fractures with age.
Better mood
Some people report improved mood, focus, and memory with HRT, as it may alleviate anxiety, depression, and brain fog linked to hormonal imbalances.
Sex drive
HRT can enhance libido and improve vaginal lubrication, addressing sexual issues that sometimes arise with aging.
Heart health
Estrogen may have a protective effect on the cardiovascular system when started early in menopause. However, timing and individual risk factors are crucial.
Potential risks of HRT
Long-term use of certain forms of HRT has been associated with increased risks of breast cancer, blood clots, and stroke, depending on the individual’s health and the type of therapy used. Plus,in general, the effects of HRT differ from person to person. Some may experience dramatic improvements, while others see minimal changes or have side effects.
As a footnote to my HRT experience, my doctor also suggested phasing in testosterone, in addition to the two standards, estrogen and progesterone. The testosterone could help with energy, libido, mood and bone health. Again, I wasn’t suffering from any of these things, but who doesn’t love a boost? While public perception still holds that
testosterone is the male hormone, and estrogen, the
female. But that contradicts the facts: There is more testosterone than estrogen in a premenopausal woman’s body.
Some doctors prescribe testosterone as a potential source of relief for such symptoms, though there isn’t a testosterone product approved by the Food and Drug Administration for female use. Within the medical community there’s controversy about whether testosterone treatments should go mainstream, or if it’s an option that would help very few. Again, my doctor was up on the latest research that suggests testosterone offers many benefits and few drawbacks. Women who take testosterone during menopause also report more energy, lower
levels of depression and increased
muscle mass.
Yet agreement on the importance of testosterone treatment is far from universal, even among menopause specialists. Additionally, since there is no product designed for female use, it’s considered off-label and women have to pay out-of-pocket for it. The most convenient option is getting testosterone at the right dose from a compounding pharmacy. This offers less guarantee of the product’s consistency and quality. It comes as a cream—absorbed by the bloodstream—which is applied to the skin of the legs or arms and. The does [dose] is roughly a tenth of what is prescribed to men, and the cost is approximately $30 a month.
Although these days testosterone is chiefly prescribed for women with low sex drive, its impact goes way beyond the bedroom. Testosterone receptors are all over your body means it can also strengthen nerves in the brain and contribute to mental sharpness and clarity. It can also help regulate serotonin levels and plays a role in its uptake in your brain, which helps improve overall mood. Since I’ve been on HRT, I lost those intractable pounds around my middle, sleep deeper, feel less stiff, and have more gusto for life (in the bedroom as well). It’s the type of good news you want to go tell on the mountain—being sure that everybody hears.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_text_separator title="Featured Products" border_width="2"][vc_row_inner equal_height="yes" content_placement="middle" gap="35"][vc_column_inner width="1/3"][vc_single_image image="181872" img_size="full" alignment="center" onclick="custom_link" img_link_target="_blank" css=".vc_custom_1738274804091{padding-right: 7% !important;padding-left: 7% !important;}" link="https://www.vitacost.com/olly-mellow-menopause-relief-for-hot-flashes-with-estrog-100-gaba"][/vc_column_inner][vc_column_inner width="1/3"][vc_single_image image="181871" img_size="full" alignment="center" onclick="custom_link" img_link_target="_blank" css=".vc_custom_1738274825907{padding-right: 7% !important;padding-left: 7% !important;}" link="https://www.vitacost.com/natures-craft-menopause-support-120-capsules"][/vc_column_inner][vc_column_inner width="1/3"][vc_single_image image="181873" img_size="full" alignment="center" onclick="custom_link" img_link_target="_blank" css=".vc_custom_1738274845219{padding-right: 7% !important;padding-left: 7% !important;}" link="https://www.vitacost.com/fairhaven-health-complete-menopause-relief-support-for-13-major-symptoms-including-hot-flashes-and-mood"][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row]
