
As a woman in the throes of perimenopause, I never considered HRT/MHT or even knew what it was until I interviewed Dr Rebecca Lewis from the Newson Health Clinic in the UK. And from then, I have observed a lot of "shouting".
As a keen learner and open to the latest evidence and research in women's health, I have kept up to speed on HRT/MHT position statements internationally and in New Zealand. To put it simply, the evidence supports HRT as the "gold standard" treatment for a range of menopause symptoms and as protection for future health issues.
When I say there is a lot of "shouting" when it comes to HRT or MHT or HT or any version you want to call it, I am highlighting how it seems you have to choose a "side". Those who insist that one should walk through menopause without "medicalizing" it and those who insist that if you aren't using it, you're mad!Â
From my perspective, and the perspective of my menopossé - doctors, fitness professionals, and menopause educators - the menopause journey is personal and unique and there are many options that you can tap into to manage symptoms that are affecting your quality of life. But you can't knock the evidence and that is "Hormone therapy is the most effective treatment for VMS and GSM and has been shown to prevent bone loss and fracture". Menopause: The Journal of the The North American Menopause Society, Vol.29, No.7, pp. 767-794 (May 2022)
To provide some context as to why I'm spending time writing about the benefits of HRT, let me take you back 3 years. I had spent the better part of 4 years focused on getting the worst of my perimenopause symptoms under control. I started with SLEEP because I knew that with poor sleep, I was messing with my hormones as they were on their own natural slippery slope.
I adjusted my NUTRITION towards an anti-inflammatory menu with added protein supplementation to support rapid muscle loss (sarcopenia). I reduced my alcohol intake. I practiced yoga daily to help my tired and sore muscles. I wrote in my journal and meditated every morning. All of these lifestyle changes helped immensely....and yet...I still forgot far too many names and had anxiety, my joints ached liked I was older than 50 years and I was MEAN. I felt like I used to be so positive and that had slipped away and taken motivation with it!
When I first heard of HRT, I never considered as a fitness professional that I shouldn't be a candidate. I researched it. Body-identical regulated hormone replacement therapy. OK, my hormones had left the building and taken a lot of daily joy with them, so why not see what all the hype was about? I was aware of the shouting - "You're a fitness professional! You should know what you need to do to manage your symptoms!" Damn straight I knew what to do BUT the lasting symptoms that hung around were robbing me of my joyful life and putting strain on my marriage. There it is - the stuff that people don't share.Â
I also felt that if I was going to sit across all aspects of menopause health, wellness and care, knowing the benefits of HRT was worth trying. At least I would discover if it was going to work for me or not. In having said that, my fellow fitness professional, Amanda Thebe, had also tried HRT and it hadn't worked out for her. We have discussed this and we both have the exact same stance - get educated, build your foundations for healthy ageing and consider the options which include HRT or not.
HRT works for me - no joint pain, better sleep, emotionally balanced, feeling happy. And the research from the NAMS position statement tells us this:
Hormone Therapy has been shown to relieve VMS (Vasomotor symptoms - hot flashes/flushes and sweats) and is FDA-approved as the first line of therapy for moderate to severe VMS. VMS is also associated with sleep disruption, mood fluctuations, memory problems, metabolic syndrome, obesity, and other cardiovascular risk factors.
Hormone Therapy has been shown to prevent bone loss and reduce fractures in post-menopausal women without osteoporosis.
Hormone Therapy has been shown to effectively treat symptoms of VVA - vulvovaginal atrophy - dryness, pain and irritation of the vagina.
Estrogen therapy, along with pelvic floor training, has shown a decreased incidence of incontinence.
Hormone Therapy has been shown to improve sexual function - increasing lubrication, blood flow and sensation of vaginal tissue. So if you feel like your libido has taken a plummet, HRT can help with that too.Â
Estrogen therapy appears to have a beneficial affect on skin thickness, elasticity and collagen
Hormone Therapy significantly reduces the diagnosis of new Type-2 diabetes, but it's not government-approved for this indication.
OK, but what about the breast cancer risk? The same position statement goes on to report:
The risk of breast cancer related to hormone therapy use is LOW. Women should be counselled about the risk of breast cancer with hormone therapy, putting the data into perspective, which shows a similar risk to that of two daily alcoholic beverages, obesity and low physical activity.Â
In a nutshell, family history aside, you have as much risk, if not more, of getting breast cancer by drinking alcohol daily and not exercising.Â
And how long can we take HRT for?
The results in managing menopause symptoms is most favourable when initiated in healthy women aged younger than 60 years or within 10 years of the onset of menopause.Â
HRT for women aged 60+ requires more careful consideration of the individual benefits and risks.
My core message is that this information is readily available online. Speak with your GP or health provider to discuss HRT further. Track your symptoms before your appointment and discuss HOW you might want to manage those.
For non-HRT management, you could also join the Sexy Ageing community in the Sexy Ageing App for your fitness and nutrition needs. For more information on HRT/MHT, check out these podcast episodes "The one about HRT" with Dr Rebecca Lewis (Newson Clinic, UK) "When MHT isn't working" with Dr Sunita Chelva (Here Menopause Clinic, Australia) "The tea on testosterone" with Dr Shahzadi Harper (The Harper Clinic, UK)
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