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Integrative Family Health Clinic in Bolton and the Greater Caledon Area
4-22 Simona Drive
Bolton, ON

Hormone Therapy: Is it Right for You?

Women often become curious about hormone therapy (HT) or hormone replacement therapy (HRT) as they experience symptoms associated with hormonal imbalances. These symptoms can vary widely but commonly include hot flashes, night sweats, mood swings, fatigue, stubborn belly fat and changes in libido. For women going through the changes that come with menopause, these symptoms can be particularly bothersome and disruptive to daily life and work.

Concerns about HT often revolve around its safety, potential side effects, and whether it’s suitable for particular health conditions. Some worry about the long-term implications of hormone use, such as increased risk of certain cancers or cardiovascular issues. Others are unsure if they are the right candidate for HT, wondering if their symptoms are severe enough to warrant treatment.

This article aims to provide clarity on what hormone therapy entails, who might benefit from it, and what to expect in terms of benefits and risks. By addressing these concerns, it helps women make informed decisions about managing their hormonal health effectively.

What is Hormone Therapy? 

The term ‚Äúhormone replacement therapy‚ÄĚ or ‚ÄúHRT‚ÄĚ is no longer used for menopause because it suggests that there is a hormone deficiency that requires correcting. However, menopause is a normal part of female aging and there is a natural reduction in hormones as the ovaries no longer ovulate and cycle month to month. Therefore it does not require correction or to “replace” anything.

The overall goal of hormone therapy is to provide a small amount of hormone to reduce the distressing symptoms of menopause (i.e., hot flashes) and to protect certain organs that are very sensitive to the loss of cycling hormones in menopause. The idea is not to go above normal limits, but rather to achieve a balance where symptoms are improved and protect the long term health of bone, uterus, bladder and brain. 

HT can be tailored to individual needs and may involve estrogen, progesterone, testosterone, or a combination depending on the specific issues being addressed.

Types of Hormone Therapy

 

Estrogen

Progesterone

Testosterone

Common Conditions Treated and Prevention

Perimenopause 

Menopause

Osteoporosis and low bone mineral density 

Perimenopause

Menopause

Recurrent miscarriage

Perimenopause

Menopause

Common Symptoms Treated

Hot flashes/night sweats

Insomnia

Heavy menstrual bleeding

Vaginal dryness

Overactive bladder 

Painful intercourse

Hot flashes/night sweats

Insomnia

Heavy menstrual bleeding

Low libido

Fatigue

Mood changes

Common Side Effects

Endometrial hyperplasia 

Breast tenderness 

Headaches

Nausea

Fluid retention

Unpredictable menstrual bleeding

Mood changes

Breast tenderness 

Headaches

Nausea

Fluid retention

Changes in libido

Acne

Mood changes

Unwanted hair growth 

Fluid retention

Insomnia

Need Prescription?

Yes

Yes

Yes

Who It’s Not For (Contraindications)

If you have:

  • a high risk of cancer
  • a clotting disorder¬†
  • certain types of cardiovascular disease.

Those with a history of Major Depressive Disorder

If you have known genetic mutations including BRCA1, BRCA2, PTEN and p53

*this is not an exhaustive list

Hormone Therapy for Menopause

Hormone therapy can come in the form of oral, injectable, and topical preparations. They can be effective and impactful tools to help achieve balance. 

Different forms and preparations of hormone therapy may be recommended over others and therefore confer different benefits vs risks. For example, in a woman who experiences vaginal dryness she may be recommended the vaginal estrogen which can better help without the unwanted effects of estrogen in the rest of the body. It is important to discuss your healthcare concerns with your healthcare provider in order for them to best assess what therapies, and what forms, are better for you. 

Menopause

During menopause, hormonal changes, particularly a decrease in estrogen and progesterone levels, lead to symptoms like hot flashes, night sweats, mood swings, and vaginal dryness. Hormone therapy can alleviate these symptoms by adding in the hormones that the body no longer produces in the ovaries. It helps restore hormonal balance, easing discomfort and improving quality of life for many women.

However, hormone therapy is not appropriate for everyone, especially those with a history of certain cancers (like breast cancer), blood clots, or cardiovascular disease. Furthermore, women with known genetic mutations that include PTEN, p53, BRCA1 and BRCA2 may require a more nuanced approach to hormone therapy on a case by case basis. 

Overall, individual health factors and risks should be carefully considered and discussed with a healthcare provider before starting hormone therapy. 

Hormone Therapies and Naturopathic Medicine

Naturopathic doctors (NDs) take a comprehensive approach to hormone therapy, beginning with thorough testing and assessment to understand the individual’s hormonal profile and health status. This typically involves detailed blood tests to measure hormone levels and assess overall health markers. NDs also consider lifestyle factors, nutrition, stress levels, and environmental influences that may impact hormone balance.

Baseline testing includes routine tests on your annual blood tests, relevant hormones as well as an assessment of metabolism including blood sugar, cholesterol and liver/kidney function tests. Based on where in the menopausal transition women are experiencing symptoms, more nuanced testing may be used such as the DUTCH test. 

What sets ND care apart is the emphasis on natural and holistic approaches. NDs may recommend lifestyle modifications, dietary changes, herbal supplements, and other natural therapies alongside or instead of conventional hormone therapy. They aim to support the body’s natural ability to balance hormones and alleviate symptoms, often with a focus on long-term health and prevention.

Patients undergoing hormone therapy with an ND can expect a personalized treatment plan that addresses their unique needs and preferences, with regular monitoring to adjust therapies as necessary. The scope of practice for NDs in Ontario includes bio-identical hormones which are analogous to human hormone (not equine hormone which is conventionally used). The approach often integrates traditional medical knowledge with natural healing practices to promote overall well-being.

Alternatives to Hormone Therapy

Metabolic Reset Program

It is a known phenomenon that women will have an increase in abdominal fat by the time they are menopausal. This stubborn belly fat happens partly due to changes in metabolism, hormones and a sedentary lifestyle. 

The Metabolic Balance program is a structured dietary and lifestyle intervention designed to address metabolic changes, particularly targeting abdominal weight gain often associated with menopause. Developed in Germany, this program focuses on optimizing metabolism through personalized nutrition plans that consider individual dietary needs and nutrient requirements based on your blood work. By emphasizing healthy eating patterns, the program aims to promote weight loss, particularly around the abdomen, and improve overall metabolic health, including high cholesterol, high blood pressure, fatty liver and prediabetes .

Those following in the Metabolic Balance program can expect guidance on portion control, food choices, and meal timing tailored to their metabolic needs. There are 4 phases to this program where the last phase is lifelong sustainable eating for your health. There is no fad dieting here! 

Find out more about whether you are a good candidate for the Metabolic Balance program.

Botanical Medicine

Botanical medicine, also known as herbal medicine, offers an alternative approach to menopausal hormone therapy. Plants like black cohosh, red clover, and dong quai are commonly used to alleviate menopausal symptoms such as hot flashes and mood swings. 

Pros

Cons

While botanical medicine offers a natural and potentially safer alternative for managing menopausal symptoms, its effectiveness and suitability should be carefully evaluated in consultation with a qualified healthcare provider. Botanical medicines can interact with medications or other supplements, so it’s crucial to consult a healthcare provider before considering its use for menopause.

Stress Management

Stress management techniques provide a non-drug approach to alleviating menopausal symptoms, focusing on reducing stress levels that can exacerbate symptoms like hot flashes, mood swings, and sleep disturbances.

Pros

Cons

In summary, stress management techniques offer a valuable alternative or complementary approach to hormone therapy for managing menopausal symptoms, focusing on improving overall resilience and well-being through lifestyle adjustments and psychological support.

Other Therapies that Support Hormonal Changes

Cognitive-behavioral therapy (CBT) helps manage hot flashes and night sweats in menopause by teaching techniques to challenge and change negative thought patterns and behaviors that may exacerbate symptoms like hot flashes and night sweats. It promotes relaxation, stress reduction, and adaptive coping strategies, improving overall symptom perception and management.

Acupuncture helps alleviate symptoms in menopause by regulating hormonal balance, reducing sympathetic nervous system activity, and enhancing endorphin release. This ancient Chinese therapy involves inserting thin needles at specific points to restore energy flow, promoting relaxation and potentially reducing the frequency and intensity of hot flashes and night sweats.

Want to learn more about hormone replacement therapy? Our hormone experts are ready to chat!

four stages of menopause wildflower health and wellness clinic

Is This Menopause? The Stages of Menopause

Menopause is a milestone of women’s health. But how do you know if you’re going through menopause (perimenopause) or have passed it (post-menopause)? Learn more about how menopause is diagnosed and how you can support yourself through this phase naturally.

Quick Facts

      • There are four stages that women go through: Pre-menopause, perimenopause, menopause, and post-menopause
      • Menopausal symptoms occur as a natural shift in hormone production with age
      • There are ways to support your hormones¬†naturally to promote a smooth transition from one hormonal phase to the next¬†

What are the female hormones and what do they do?

There are two major female hormones: 

Hormone Produced By Function
Estrogen Mainly by the ovaries, to a lesser extent by the adrenal glands and fat cells Effects include regulating the menstrual cycle; maintaining: muscles and connective tissue, heart and blood vessels, brain, bones, skin, and hair.
Progesterone Mainly by the corpus luteum in the ovaries, to a lesser extent by the adrenal glands Prepares the uterine lining for pregnancy; maintaining pregnancy; and supporting thyroid function, mood, and breastmilk production.

Source: Johns Hopkins Medicine, Cleveland Clinic

The stages of menopause

There are generally four stages of female hormones in a woman’s lifetime:¬†

      1. Premenopause: This is the period of time when both estrogen and progesterone are sufficient in levels to produce regular menstrual cycles and to support a potential pregnancy.
      2. Perimenopause: This means “around menopause,” which begins when periods become less regular, typically around a woman’s 40s.¬†
      3. Menopause: This stage starts from the last menstrual period until the post-menopausal stage, 12 months later. This stage is typically when menopausal symptoms like hot flashes and sleeplessness are most intense. 
      4. Post-menopause: This stage comes after 12 consecutive months without a period. 

What happens during menopause?

During perimenopause, the ovaries down-shift their production of estrogen and progesterone. When levels of these hormones are no longer optimal to produce a regular menstrual cycle, menopause starts, and so can the symptoms of menopause.

Typical symptoms that occur during menopause as a result of these hormonal changes are: 

      • hot flashes
      • sleeplessness
      • low energy
      • low libido
      • vaginal dryness
      • night sweats
      • weight gain
      • bloating¬†
      • mood changes

Although these symptoms are¬†common, they’re¬†not normal, and there are ways to support your hormonal transition without experiencing intense symptoms that disrupt your day-to-day life.¬†

Treatment options for menopause

Treatment starts with proper assessment of your hormone levels, understanding your body’s ideal hormone levels, and how to manage your symptoms as you go through menopause.¬†

Depending on your case, your healthcare provider may suggest one or a combination of the following:

      • Hormone replacement therapy
      • Lifestyle modifications
      • Stress management
      • Natural remedies, such as botanical medicines
      • Other supportive therapies, such as acupuncture

You don't have to go through menopause or perimenopause alone.

Wildflower clinicians are here to support you through a comfortable transition through menopause.