Hormone Replacement Therapy was once considered to be the panacea for all peri /menopausal symptoms and then that all changed when back in 2002, research suggested that HRT increased the risk substantially for breast cancer.
Research since then (which has been largely ignored), has subsequently shown that it is not as clear cut as this and age and time after menopause onset has an influence on outcomes.
Women who start HRT within 10 years of menopause and who are under 60 years old have less risk of breast cancer and more health benefits such as reduced hot flushes and painful sex and reduced risk of cardiovascular disease and osteoporosis (Langer, 2017)
Hormones most likely needing replacement
Progesterone is the first reproductive hormone to decline so this is sometimes the hormone that should be replaced first and evidence suggests that taking bio-identical progesterone may have benefits and is a safer form of HRT than oestrogen alone.
Many of the menopausal symptoms that we experience during peri-menopause can be linked to declining progesterone. Bio-identical progesterone (aka as body-identical) is progesterone that is synthetic (usually made from plants) but identical on a molecular level to the hormones we make ourselves.
In the past hormones used in HRT were from animals and had severe side effects. Bio-identical progesterone has been shown to help reduce heavy periods, relieve mood swings and anxiety, improve sleep and may prevent breast cancer (Prior, 2018)
It is important to note that synthetic progestins, which are sometimes used are not considered as safe as synthetic progesterone. Studies show it to be more potent and may be linked to an increased risk of breast cancer (Asi et al, 2016)
Oestrogen doesn’t have as good a safety profile as bio-identical progesterone, used together they exert more benefit and vaginal and transdermal (via the skin) oestrogen may be safer than oral oestrogen. This is because they bypass the gut and liver and so aren’t transformed into more dangerous metabolites.
All bio-identical hormones are prescribed by a GP and have their place. Nutrition, herbs and lifestyle can all make a massive difference but when they don’t then HRT may be worth considering and are certainly better options that anti-depressants and the oral contraceptive oil. I have had clients that have seen huge improvements in their quality of life with trans dermal bio identical progesterone but only as a last resort.