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What Every Woman Should Know About Hormone Replacement Therapy in Perimenopause

Writer's picture: Jennifer GrahamJennifer Graham

Let’s be honest! Once we get into our 40’s, everything starts to feel a bit different. We start getting aches and pains that weren’t there in our 30’s, our fuses are a bit shorter than usual, weight creeps up on us and is harder to get off, and our skin is changing, and not for the better. Our providers are telling us that it’s a normal part of aging and to “just deal with it” or “it’s all in your head” and “your labs look fine”. But I’m here to tell you, we DON’t have to “just deal with it”. There are ways that we can lessen these symptoms AND protect ourselves against heart disease, Alzheimer’s, osteoporosis and keep our sanity.


Have you heard the term perimenopause and wondered what exactly that meant and how long you will be in perimenopause?


Simply put, perimenopause is a period of time (on average 4 years, but can be up to 10 years) in a woman’s life that leads up to menopause when hormone levels begin to fluctuate/decline, and symptoms such as hot flashes, mood swings, and irregular periods start to emerge.


Navigating these fluctuations and symptoms can be challenging to say the least, but don’t worry, hormone replacement therapy (HRT) can help you feel more empowered to take control of your health, well-being and sanity.


What is Hormone Replacement Therapy (HRT)?


Hormone replacement therapy involves supplementing the body with hormones that naturally decrease during perimenopause, primarily estrogen and progesterone. In some cases, testosterone & thyroid replacement may also be included. HRT aims to alleviate symptoms caused by hormonal imbalances and support overall health during this transitional phase.


Common Symptoms of Perimenopause


Every woman’s experience with perimenopause is unique, but some of the most common symptoms include:


  • Hot flashes and/or night sweats

  • Mood swings, irritability & anxiety

  • Fatigue and brain fog

  • Sleep disturbances

  • Decreased libido

  • Vaginal dryness

  • Painful intercourse

  • Weight changes

  • Thinning hair or hair loss

  • Heart palpitations

  • Dry mouth


These symptoms can range from mild to severe, impacting a woman’s daily life and overall quality of life.


Types of Hormone Replacement Therapy


The best part of HRT (besides symptom relief) is that it’s 100% customizable to YOUR individual needs. It often takes a few different doses and routes of medication to get the perfect recipe just for you. can be customized to meet the specific needs of each woman.


The main types of HRT include:


1. Estrogen Therapy: Used to alleviate symptoms like hot flashes, vaginal dryness, and bone loss. Estrogen can be delivered through pills, patches, creams, or gels.


2. Combination Therapy (Estrogen and Progesterone): This is recommended for women with an intact uterus to reduce the risk of endometrial cancer. It helps manage a broader range of symptoms while maintaining uterine health.


3. Testosterone Therapy: Although less commonly discussed, testosterone replacement can help women experiencing low libido, fatigue, and muscle weakness during perimenopause.


Benefits of Hormone Replacement Therapy


HRT offers numerous benefits for women in perimenopause, including:


  • Symptom Relief

    • HRT is highly effective at reducing hot flashes, night sweats, and vaginal dryness.

  • Improved Sleep

  • By stabilizing hormone levels, many women experience better sleep quality.

  • Bone Health

  • Estrogen plays a key role in maintaining bone density, reducing the risk of osteoporosis.

  • Mood Stabilization

  • Many women find relief from mood swings and irritability with balanced hormones.

  • Enhanced Energy and Vitality

  • Testosterone therapy can improve overall energy levels and restore a sense of vitality.


Is Hormone Replacement Therapy (HRT) Safe?


Safety concerns about HRT, primarily stemming from earlier studies, have evolved with modern research. Today’s HRT options are more refined and customizable, allowing for lower doses and delivery methods that reduce risks. Working with a knowledgeable healthcare provider is crucial to determine if HRT is right for you and to create a plan tailored to your needs.



How to Get Started with HRT


If you’re considering HRT, the first step is to book a consult. I offer a free 20 minute online introductory consultation to see if HRT is right for you.


You’ve decided to move forward with HRT, yay! Here’s what to expect:


  1. Initial appointment

  2. Comprehensive physical assessment

  3. Review of your medical history, symptoms, and lifestyle

  4. Draw lab work to evaluate your current hormone status


2. Individualized and customized plan

Based on your labs, physical assessment, medical history and symptoms, a customized plan will be developed with your input.


3. Ongoing Monitoring

A follow-up appointment will be scheduled in 3 months to review your updated lab results, assess symptom improvement, and adjust medications as needed to ensure your hormone therapy is effectively supporting your health and well-being.


To Sum It Up


Perimenopause is a natural stage of life, but it doesn’t have to diminish your quality of life. Hormone replacement therapy offers a powerful tool for managing symptoms and supporting overall health during this transition. By understanding your options and working closely with a provider, you can make informed choices to thrive through perimenopause and beyond.


Ready to explore how HRT can help you?


Schedule a free 20 minute introductory consultation today to discuss your symptoms and create a personalized plan tailored to your unique needs.



References

  1. North American Menopause Society (NAMS). (2021). The 2021 Position Statement on Hormone Therapy. Retrieved from https://www.menopause.org

  2. Harvard Health Publishing. (2022). Hormone therapy: Is it right for you? Retrieved from https://www.health.harvard.edu

  3. Mayo Clinic. (2022). Hormone replacement therapy: Benefits and risks. Retrieved from https://www.mayoclinic.org

  4. Women’s Health Concern. (2023). Understanding menopause and hormone replacement therapy. Retrieved from https://www.womens-health-concern.org

  5. National Institutes of Health (NIH). (2022). Alternatives to hormone therapy for menopause symptoms. Retrieved from https://www.nih.gov

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