Menopause Series, Part 4:
What the Research Really Says About HRT and Menopause
Have you been told that hormone therapy is dangerous or increases your cancer risk? Is hormone therapy safe? Research says yes.
That message has kept many people from getting relief during menopause. However, newer research paints a very different and much more hopeful picture about hormone therapy and its safety when used correctly.
What We Used to Believe
Back in the early 2000s, the Women’s Health Initiative, or WHI, study raised concerns about hormone therapy and its possible link to cancer and cardiovascular problems. The media widely reported these findings, and many healthcare providers became cautious or stopped recommending hormone therapy altogether. Patients were often told to avoid it to reduce their cancer risk.
But those early findings were not the full story. The study included older women who had been menopausal for many years before starting hormone therapy. This timing affected how the results applied to people just beginning menopause or perimenopause.
What We Know Now
Recent studies have clarified many of the misunderstandings from the WHI. Today, we know that hormone therapy is much safer than previously thought, especially when started near the time of menopause. Starting hormone therapy at this time can provide benefits that outweigh the risks for many patients.
Estrogen therapy, in particular, may protect against heart disease, cognitive decline, and bone loss when used appropriately. The type of estrogen and progesterone, the method of delivery, and timing all matter in determining safety and effectiveness.
A large review published in 2023 in the journal Menopause examined current research and showed that the risk of breast cancer associated with hormone therapy is lower than previously believed. This is especially true when using transdermal estrogen, which is absorbed through the skin, and natural progesterone rather than synthetic versions.
The review also highlighted the risks of not treating menopause. When left unmanaged, menopause can increase inflammation, accelerate bone thinning, and raise the risk of cardiovascular disease. These risks demonstrate that avoiding hormone therapy out of fear may lead to other serious health consequences.
Understanding the Risk of Doing Nothing
When estrogen levels drop and remain low during and after menopause, the body experiences many changes that increase health risks. These include:
- Increased risk of cardiovascular disease due to loss of estrogen’s protective effect on blood vessels. Estrogen helps maintain vessel flexibility and reduces inflammation, so low levels contribute to plaque buildup and heart problems.
- Osteoporosis and a higher chance of fractures because estrogen helps keep bones strong. Without enough estrogen, bone density decreases more quickly.
- Changes in mood and memory linked to estrogen’s role in the brain. Low estrogen levels may contribute to anxiety, depression, brain fog, and difficulties with concentration.
- Persistent weight gain and insulin resistance. Lower estrogen slows metabolism and makes it harder to maintain a healthy weight, increasing the risk of type 2 diabetes and metabolic syndrome.
Ignoring these risks and doing nothing about hormonal imbalance is a decision that can have serious consequences for long-term health.
Hormone Therapy Can Be Personalized and Safe
Hormone replacement therapy is not one-size-fits-all. It should be carefully managed and personalized to each individual’s needs, health history, and risk factors. When done right, it can provide significant benefits such as:
- Relief from hot flashes, night sweats, and other menopausal symptoms
- Improved bone density and reduced fracture risk
- Better cardiovascular health
- Enhanced mood, sleep quality, and cognitive function
- Support for healthy body composition and metabolism
Healthcare providers now use more tailored approaches, including bioidentical hormones that match your body’s natural hormones more closely. Delivery methods like patches, gels, or vaginal rings allow for steady hormone levels and fewer side effects.
Moving Forward with Confidence
If you have been hesitant about hormone therapy because of outdated information, know that research and medical practice have evolved. Today’s hormone therapy options offer a safe and effective way to support your health through menopause and beyond.
Ready to learn more about whether hormone therapy might be right for you?
- Schedule a FREE consultation with Parker Mason Wellness to discuss your symptoms, get tested, and explore personalized hormone balance solutions.
Source:
[1] Langer RD. Revisiting the Women’s Health Initiative: The Past and Future of Hormone Therapy. Menopause. 2023;30(2):125-130.
