Hormone Replacement Therapy in 2019 – What do we know now?

Here at Maze, we get lots of concerned questions about hormone replacement therapy (HRT).  When should I start? Is it safe? How long can I stay on it?  When asked these types of questions, we always focus on what the evidence tells us.  Recently, Dr. Joann Pinkerton (director of the North American Menopause Society, aka the experts on menopause!) put together a really great video highlighting the key messages from the NAMS position statement regarding HRT.  It provides clarity around some of the most common concerns and misconceptions about HRT during menopause.  It also helps us to understand better where the Women’s Health Initiative study (the one that got us all scared about HRT in the first place) went wrong, and what we should be focusing on as patients and clinicians, going forward. Here are my key takeaways from the video:

  • HRT is safe and effective. We can use it to safely treat hot flashes, night sweats, and to prevent bone loss.
  • Timing is everything. It’s super important to start HRT when you first start experiencing the signs and symptoms of menopause. Women who are under age 60 and within 10 years of entering menopause are great candidates.
  • We have much better (bioidentical) hormones now, then we did even 5 years ago. Long gone are the progestins that can cause problems (aka increase risk for breast cancer). 
  • Individualize the treatment. Instead of thinking “lowest dose for the shortest time”, we should think about “what is the appropriate dose and type of therapy” for each patient.
  • There is no need to cut women off. Science has shown us that women can now safely stay on hormones for 5-10 years, depending on the age that they start.  When ready to wean, a slow taper off the HRT is the way to go.

If you are having symptoms related to menopause, don’t be afraid to seek the treatment you need. The sooner the better! If you’d like to learn more about this treatment option, contact one of our Certified Menopause Practitioners for a free phone consultation.