Hormone Replacement Therapy - Is it the right fit for you?
- ambieagnes
- Jul 2
- 3 min read
It seems like everyone and their mother is now taking HRT (Hormone Replacement Therapy). When it comes to assessing whether it would be a good fit for you, it can feel impossible.
On one hand, there may be doctors who now seem too trigger happy with prescribing it without a full workup, and explanation of the risks vs benefits for your individual case.
On the other hand, the doctor you go to might not prescribe it since you’re still having a regular menstrual cycle (even though you’re struggling with all the symptoms).
Some symptoms of perimenopause can include:
hot flashes, night sweats
new or worsening anxiety, depression, rage, PMS/PMDD
brain fog, low energy, trouble with word-finding and recall
insomnia
weight gain (with more distribution around the stomach area)
challenges with urinary incontinence, recurrent infection, and other potential symptoms of Genitourinary Syndrome of Menopause (vaginal dryness, burning, irritation, pain with intercourse)
low libido
new or worsening headaches, joint/muscle pains, heart palpitations, vertigo, paresthesia (itching skin/ears, tingling gums)
Why don’t all doctors know if hormone replacement therapy is
the right fit for me?
Unfortunately, women's hormonal health has been understudied and misunderstood for decades. Since the 2002-2004 Women’s Health Initiative trials were discontinued early linked hormone therapy to breast cancer, heart disease, and stroke, many women avoided treatment for menopausal symptoms. The HERS trials (1998) also showed increased risk of cardiovascular disease in the subjects.
What are the challenges with studies on hormone replacement therapy?
Some people in these studies were:
of higher age
asymptomatic
not controlled for the number of years post-menopause
not controlled for active cardiovascular disease (many had a BMI >50, were previous smokers, and had high blood pressure needing treatment).
Also, different forms of HRT were used in these studies compared to what is used today.
A lot of re-education needs to happen after these studies generated such fear and it’s difficult to keep up with if your doctor doesn’t specialize in women’s health.
What is the most recent research showing around hormone replacement therapy?
Later reanalysis showed that early postmenopausal therapy lowered coronary disease and mortality, and estrogen alone reduced breast cancer risk (although this never reached mainstream media). More recent studies further redefined hormone safety beyond age 65, highlighting risks and benefits by formulation and delivery.
What does prescribing hormone replacement therapy look like?
If I start patients on hormone therapy, it’s a decision based on an individualized data analysis to understand if they are good candidates for hormone therapy.
We understand your hormonal health - from menstrual cycle to pregnancy history - to see if there are any increased health risks to be working on preventatively
We look at birth control use - including if an IUD is being used
We look at prior surgery, such as removal of one or both ovaries, or a partial or full hysterectomy
We look at the all of the factors, from lifestyle to genomics
We calculate baseline risks for breast cancer, cardiovascular disease, and bone health to understand what your risks and benefits go up to after starting HRT.
HRT is the icing on the cake - perimenopause is a time where cardiovascular risk and osteoporosis risk increase substantially and HRT alone is NOT going to be enough. We put together a plan to ensure that you go into menopause well set up with nutrition, lifestyle, and supplement habits to help you thrive.
If we decide to start hormone therapy, it’s going to be women who are the best candidates and only if you’re feeling comfortable after learning all the risks and benefits for YOUR case.
It's also important to consider that there are many NON-HORMONAL OPTIONS to help manage your perimenopausal symptoms. If you are not a good candidate for HRT we have so many other options to help, that we can work through.
If you’re in Mississauga or Milton and need support navigating HRT (Hormone Replacement Therapy), I’d love to help. As a Naturopathic Doctor and birth doula, I support women through fertility, pregnancy, postpartum, and perimenopause with strategies that are sustainable and realistic.
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