Though not a ‘cure-all’ hormone replacement therapy combined with a healthy diet and lifestyle could bring great relief to millions of women.
A new study has determined that, when it comes to treating the symptoms of menopause, the overall benefits of hormone replacement therapy outweigh the risks. However, researchers found that the evidence does not support hormone therapy as an effective preventative measure for cardiovascular disease, dementia, or other chronic diseases.
Study Findings Explained
The WHI study was conducted from 1993 through 1998. Participants consisted of 161,808 postmenopausal women within the United States between 50 and 79 years old. Relevant data was collected from the study participants for up to twenty years to determine the efficacy and side effects of hormone replacement therapy during menopause.
After analyzing the WHI’s follow-up data, the JAMA study researchers concluded hormone replacement therapy (HRT) is a safe treatment option for common vasomotor menopause symptoms, such as hot flashes and night sweats. The researchers also found that initiating hormone replacement therapy in early menopause (before age 60) resulted in fewer adverse effects compared to late menopause.
“I’m glad to see the researchers mention the increased risk of side effects from HRT in late menopause. I wish doctors would be more upfront with patients about the downsides of HRT, because the truth is, it doesn’t work well for a lot of women,” Mindy Pelz, a chiropractor and functional health expert, told The Epoch Times in an email.
Researchers also found the evidence did not support routine calcium and Vitamin D supplementation to prevent fractures in postmenopausal women. Nor did it support the use of a low-fat diet as a means to prevent breast or colorectal cancer in postmenopausal women.
Background and Prior Research
Through decades of research, scientists have been able to better understand which hormone treatments are beneficial–and which should be avoided. For example, researchers of the WHI study learned that a certain type of progestin—medroxyprogesterone acetate—was linked to higher rates of breast cancer. On the other hand, micronized progesterone, a type of bioidentical hormone, does not increase the risk of breast cancer.
The WHI study also found an increased incidence of pulmonary embolism in women taking estrogen orally. Other forms of estrogen, such as patches, creams, or gels, are considered a safer option because they are not metabolized by the liver.
Hormone Replacement Therapy and Menopause
Postmenopausal women account for approximately 55 million people in the United States and 1.1 billion people worldwide. During menopause, a woman’s body no longer produces adequate amounts of the hormones estrogen and progesterone. According to Dr. Rocco, this drop in hormone levels can cause uncomfortable menopause symptoms, including hot flashes, night sweats, anxiety, depression, weight gain, difficulty sleeping, and difficulty losing weight. These symptoms can last for up to ten years after the start of menopause.
Generally, if a postmenopausal woman has a uterus, they will be prescribed a combination of estrogen and progesterone. This is because progesterone can help protect women with a uterus from endometrial cancer, which can form from estrogen-only therapy. If the woman no longer has a uterus due to a hysterectomy, then they will be prescribed estrogen only.
Advantages and Disadvantages of Hormone Replacement Therapy
The most immediate advantage of HRT is relief from uncomfortable menopausal symptoms such as night sweats, hot flashes, insomnia, and vaginal dryness. Studies suggest that long-term hormone therapy can prevent bone fractures.
There is also evidence that HRT could help lower the risk of bowel cancer and prevent bone loss (osteoporosis).
Natural Alternatives to Hormone Replacement Therapy
For those who prefer not to take hormones, there are certain lifestyle changes and natural alternatives that may help alleviate menopausal symptoms. Exercise, eating a balanced diet, relaxation therapy, and yoga are all lifestyle changes that can help lessen the severity of menopausal symptoms. Avoiding potential triggers, such as caffeine, smoking, alcohol, and spicy foods, may also be beneficial.
“You’d be amazed by how much you can improve your hormone levels and ease menopause symptoms through lifestyle changes,” confirms Ms. Pelz.
As far as exercise, Ms. Pelz specifically recommends lifting weights and walking, explaining, “Weightlifting increases sex hormones, which is good for menopausal symptoms. But it does a lot more than that too. Muscle mass and bone density are two of the biggest predictors of quality of life as you age. Menopause decreases both of them—and lifting weights reverses those declines, ensuring you look and feel your best as you age. Also, walk every day.”
“It sounds basic, but research shows that low-level movement throughout the day makes a huge difference to both your hormone production and your overall health. I also think it’s one of the most underrated tools for weight loss. Aim for 10,000 steps a day if you can, but start with whatever’s possible. Even 1,000 steps a day will make a big change to how you feel if you’re consistent with it,” she adds.
Dr. Rocco agrees that dietary changes can make a huge difference. She recommends a diet rich in vegetables, plant-based foods, and clean meats, as well as reducing one’s sugar intake to improve cardiovascular health. “Additionally, reducing alcohol intake is crucial as it affects hormones and increases cortisol production, leading to weight gain. Including more lentils and yams in the diet provides phytoestrogens which can naturally increase estrogen production,” she advises.
- Black cohosh
- Red clover
- Evening primrose oil
- Lemon balm
- Fenugreek
- Fennel
- Ginkgo biloba
- Licorice
These herbal remedies can balance hormone levels and/or improve sleep, thus potentially alleviating menopause symptoms.
Dr. Rocco believes natural supplements can help menopausal women, specifically recommending green tea and DIM (diinodolylmethane) to help regulate hormones. “Taking vitamin D is beneficial as it improves the immune system and helps mitigate depression and anxiety linked to low vitamin D levels. Avoiding gummy vitamins is advisable due to their shorter half-life and sugar content,” she says.