Research Indicates Hormone Replacement Therapy is a Safe and Effective Treatment for Menopause Symptoms

A recent study has concluded that hormone replacement therapy is more beneficial than risky when it comes to managing menopausal symptoms. However, the evidence does not support using hormone therapy as a preventive measure for cardiovascular disease, dementia, or other chronic conditions.

After reviewing the follow-up data from the WHI, the JAMA study researchers found that hormone replacement therapy (HRT) is a safe option for alleviating common menopause symptoms like hot flashes and night sweats. They also observed that starting HRT in early menopause (before age 60) led to fewer adverse effects compared to starting later.

According to Mindy Pelz, a chiropractor and functional health expert, there are increased risks of side effects from HRT in late menopause. She emphasizes the importance of being transparent with patients about the limitations of HRT.

The study also found that there is no evidence supporting the use of calcium and Vitamin D supplements to prevent fractures in postmenopausal women, nor does it endorse a low-fat diet for preventing breast or colorectal cancer in postmenopausal women.

Ms. Pelz notes, “HRT can significantly improve menopause symptoms for some women, but it’s crucial to understand that it doesn’t shield against the effects of menopause on heart health, brain aging, and chronic disease risk.”

Previous Research

Through years of research, scientists have identified beneficial hormone treatments and others to avoid. For instance, the WHI study revealed that a specific progestin (medroxyprogesterone acetate) was linked to an increased risk of breast cancer. In contrast, micronized progesterone, a type of bioidentical hormone, does not raise breast cancer risk.

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“Bioidentical hormones are a safer alternative to traditional HRT as they are plant-based transdermal creams structurally identical to human hormones. They are recognized, metabolized, and excreted by the body, activating the same functions as before menopause. Bioidentical hormones are equally effective in alleviating hot flashes, night sweats, weight gain, and sleep disturbances without increasing the risk of breast cancer, heart disease, blood clots, or strokes,” explained Dr. Gowri Reddy Rocco, a double board-certified physician in family medicine and regenerative, anti-aging, and functional medicine.

The WHI study also reported a higher occurrence of pulmonary embolism in women using oral estrogen. Other estrogen forms such as patches, creams, or gels are considered safer since they are not metabolized by the liver.

Dr. Rocco pointed out that the WHI study focused only on synthetic, oral estrogens and progestins, not bioidentical hormones (BHRT) or physiological studies. It’s essential to distinguish traditional synthetic HRT from BHRT to ensure women are knowledgeable about the options.

Hormone Replacement Therapy and Menopause

Approximately 55 million women in the US and 1.1 billion globally are postmenopausal. During menopause, the body decreases estrogen and progesterone production, leading to uncomfortable symptoms like hot flashes, night sweats, anxiety, depression, weight gain, sleep issues, and difficulty losing weight. Dr. Rocco explains that these symptoms can persist for up to ten years after menopause begins.

Generally, postmenopausal women with a uterus are prescribed a combination of estrogen and progesterone to protect against endometrial cancer. Women without a uterus due to a hysterectomy receive estrogen only.

Studies suggest that HRT could also decrease the risk of colon cancer and prevent bone loss (osteoporosis).

“Lifestyle changes can significantly improve hormone levels and ease menopause symptoms,” confirms Ms. Pelz.

In terms of physical activity, Ms. Pelz specifically recommends weightlifting and walking. She explains, “Weightlifting boosts sex hormones, which can benefit menopausal symptoms and more. Muscle mass and bone density are vital for quality of life as you age, and weightlifting counters the decline triggered by menopause. Additionally, walking daily is beneficial.”

“It may sound basic, but consistent low-level movement throughout the day boosts hormone production and overall health. It’s also an underrated tool for weight loss. Aim for 10,000 steps daily if possible, but start with whatever you can manage. Even 1,000 daily steps can make a significant difference with consistency,” she adds.

Dr. Rocco likewise emphasizes the impact of dietary changes. She recommends a diet rich in vegetables, plant-based foods, lean meats, and reducing sugar intake to enhance heart health. “Limiting alcohol is crucial as it affects hormones and boosts cortisol production, leading to weight gain. Including lentils and yams in the diet can provide phytoestrogens that naturally increase estrogen production,” she advises.

Dr. Rocco suggests that natural supplements like green tea and DIM (diindolylmethane) can regulate hormones and benefit menopausal women. “Vitamin D supplementation enhances the immune system, mitigates depression and anxiety linked to low vitamin D levels, and avoiding gummy vitamins is preferable due to their shorter half-life and sugar content,” she notes.