Integrative Family Health Clinic in Bolton and the Greater Caledon Area
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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





Common Conditions Treated and Prevention



Osteoporosis and low bone mineral density 



Recurrent miscarriage



Common Symptoms Treated

Hot flashes/night sweats


Heavy menstrual bleeding

Vaginal dryness

Overactive bladder 

Painful intercourse

Hot flashes/night sweats


Heavy menstrual bleeding

Low libido


Mood changes

Common Side Effects

Endometrial hyperplasia 

Breast tenderness 



Fluid retention

Unpredictable menstrual bleeding

Mood changes

Breast tenderness 



Fluid retention

Changes in libido


Mood changes

Unwanted hair growth 

Fluid retention


Need Prescription?




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. 


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. 



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.



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!

5 Things You Should Know About Menopause

Menopause, a pivotal life transition, marks the end of a woman’s menstrual cycles and signifies the conclusion of her reproductive years. The menopausal shift gives rise to a spectrum of physical and emotional changes, ranging from hot flashes and night sweats to mood swings and changes in bone density. 

Beyond the physiological aspects, menopause also carries psychological and emotional dimensions, impacting a woman’s sense of identity and well-being. Navigating this transformative period involves understanding the diverse manifestations of menopausal symptoms, exploring available treatment options, and embracing lifestyle adjustments to promote overall health and resilience. 

What is Menopause?

Menopause is a natural part of a woman’s life that occurs when the ovaries stop releasing eggs and producing the hormones estrogen and progesterone. 

There are a few phases to menopause, starting with perimenopause and ending in postmenopause: 


Perimenopause refers to the transitional stage leading up to menopause, typically beginning in a woman's 40s but sometimes starting earlier.

During perimenopause, hormone levels, particularly estrogen and progesterone, begin to fluctuate, leading to irregular menstrual cycles and various symptoms such as hot flashes, night sweats, mood swings, fatigue, and changes in libido.

Perimenopause can last for several years, and the duration varies from woman to woman. It ends when a woman has not had a menstrual period for 12 consecutive months, marking the onset of menopause.


Menopause marks the end of a woman's menstrual cycles and fertility. It is defined as the absence of menstruation for 12 consecutive months.

The average age of natural menopause in women is around 51, but it can occur earlier or later. Factors such as genetics, smoking, and certain medical conditions can influence the timing of menopause.


Postmenopause refers to the stage of life after menopause has been reached. It begins the day after a woman has gone 12 months without a menstrual period.

During postmenopause, hormone levels, particularly estrogen, remain at consistently low levels. As a result, women may continue to experience symptoms such as vaginal dryness, hot flashes, and mood changes.

Postmenopausal women are at increased risk of certain health conditions, including osteoporosis (due to decreased bone density), cardiovascular disease, and cognitive changes.

Understanding the stages of menopause can help women navigate the physical and emotional changes associated with menopause and make informed decisions about their health and well-being.

Hormones in Menopause

The hormonal changes during menopause involve more than just a decrease in estrogen. The interplay of hormones from various glands, including the thyroid, pancreas, adrenals, and ovaries, is intricate and dynamic. It is crucial for your provider to understand how each hormone interacts and compensates for one another in order to help you achieve hormonal balance during menopause.


Here are some key hormonal glands that your healthcare provider may consider:

  1. Thyroid gland – Thyroid disorders can mimic peri/menopausal symptoms such as weight gain, mood changes, fatigue, hair loss and sleep disturbance.
  2. Ovaries – Ovaries are the primary reproductive organs responsible for producing estrogen, progesterone, and small amounts of testosterone. During menopause, ovarian function declines, leading to a decrease in estrogen and progesterone production.
  3. Pancreas – The pancreas produces insulin, which helps regulate blood sugar levels and may influence weight management during menopause.
  4. Adrenals – Chronic stress during menopause can lead to dysregulation of adrenal function, resulting in symptoms such as fatigue, mood swings, and sleep disturbances. The adrenals are responsible for the stress response and take over production of estrogen, progesterone and testosterone in menopause.

Five Things You Need To Know About Hormones in Menopause

Here are five ways that hormones can impact your health during the different phases of menopause: 

  1. Hormones Fluctuate During Perimenopause:
    Perimenopause is characterized by fluctuating hormone levels, particularly estrogen and progesterone. These fluctuations can lead to irregular periods, hot flashes, mood swings, and other symptoms as the body adjusts to changing hormone levels. During this phase, testing for hormones can be a moving target. Collaborating with your healthcare professional can help avoid the trial-and-error approach when experimenting with various products and supplements.

  2. Low Hormone Levels in Postmenopause:
    After menopause, women experience a significant decrease in estrogen and progesterone levels, leading to various changes in the body. These changes can include decreased bone density, increased risk of cardiovascular disease, and changes in cognitive function.
  3. Hormones Impact Bones, the Brain, and the Cardiovascular System:
    The decrease in hormone levels postmenopause can have profound effects on bone health, brain function, and cardiovascular health. Estrogen plays a crucial role in maintaining bone density, so low estrogen levels can increase the risk of osteoporosis. Additionally, estrogen has neuroprotective effects and helps regulate the cardiovascular system, so its decline can affect brain function and cardiovascular health.
  4. Menopause is More Than Just About Estrogen and Progesterone:
    Menopause involves a complex interplay of hormones beyond just estrogen. While estrogen levels decline, other hormones such as progesterone, testosterone, and hormones produced by the adrenal glands also play a role in menopausal symptoms and overall health. Understanding how these hormones interact and compensate for each other is essential for managing menopausal symptoms and promoting overall well-being.
  5. Balancing Hormones Isn’t A One-Size-Fits-All:
    Achieving hormone balance during menopause involves more than just replacing estrogen. It requires a comprehensive approach that considers the interactions between various hormones and addresses individual symptoms and health concerns. This may involve lifestyle changes, hormone therapy, nutritional support, and other interventions tailored to each woman’s needs.

By understanding the complexities of menopause and its impact on hormone levels, women can take proactive steps to manage symptoms, support their overall health, and navigate this important life transition more effectively.

How Naturopathic Doctors Help

Naturopathic doctors (NDs) take a holistic approach to assess and treat menopausal symptoms and related health concerns. They consider the interconnectedness of various bodily systems and focus on addressing the underlying causes of symptoms rather than merely managing them.

Menopause is a significant life transition that can bring physical, emotional, and psychological changes for women. Naturopathic medicine offers holistic approaches to assess and treat menopausal symptoms, emphasizing individualized care, lifestyle modifications, natural therapies, and mind-body interventions. If you’re experiencing menopausal symptoms or approaching menopause, consult with a licensed naturopathic doctor to explore safe and effective treatment options tailored to your needs and goals.

Get started with Dr. Salwan, ND or one of our NDs at Wildflower Health and Wellness today.