From the desk of Dr. Meagan
Back in 2002, before Meta and definitely before cancel culture, the Women’s Health Initiative (WHI) study on hormone replacement therapy (HRT) was released. The study made headlines because it suggested that HRT, particularly the combination of estrogen and progestin, increased the risk of breast cancer, heart disease, stroke, blood clots–you name it. Consequently, the study led to widespread fear, and like platform flip-flops and frosty highlights, HRT was *canceled.*
But here’s the thing: that study wasn’t the full picture. Since then, the WHI study has been re-evaluated and criticized for several reasons, including the age of the participants (most were older and postmenopausal), the types of hormones used, and the dosage levels, which don’t necessarily apply to younger, perimenopausal women.
More recent research has shown that when HRT is appropriately tailored to the individual—considering factors like age, health history, and the timing of therapy—it is effective and safe. Studies like the KEEPS (Kronos Early Estrogen Prevention Study) and the ELITE (Early versus Late Intervention Trial with Estradiol) demonstrate that when HRT is started closer to the onset of menopause, it’s not only safer but can actually be highly beneficial. Think better bone health, a possible reduced risk of heart disease, and an overall improved quality of life. Studies have also proven that the risk of breast cancer with HRT is a function of the type of hormones you’re taking and your individual cancer risk profile.
So, what’s the takeaway here? Well, the landscape of HRT has evolved significantly with more nuanced research and continues to do so today. If you’re considering HRT, it’s all about personalization. It’s not one-size-fits-all, and it’s definitely worth having a heart-to-heart with your doctor about it. The bottom line is HRT can still be a good option for many women, but it’s all about finding what works best for you.
Let’s keep the conversation going, and remember—you’ve got options. We’re all in this together!
Dr Meagan
Answers worth knowing
Can you take HRT while you’re still getting periods?
Absolutely, you can! HRT can be started even if you’re still having periods, depending on your symptoms and lab results. Steps one and two in seeing if HRT is right for you are tracking your symptoms and seeing a menopause doctor.
Do I have to be on HRT forever?
Nope. The American College of Obstetricians and Gynecologists (ACOG) and The Menopause Society agree that the old philosophy of taking the lowest dose for the shortest time is outdated. But that doesn’t mean you stay on it forever. How long you stay on HRT is super individualized. Your symptoms, lab results, and collaboration with your doctor will determine when you stop HRT. It’s all about what’s best for your health and well-being.
Breast cancer runs in my family. Is it okay for me to take HRT?
Family history is important but doesn’t automatically rule out HRT. We’ll look at your personal health history, family history, and lab results to determine what’s safe and effective for you. Just because cancer runs in your family doesn’t mean you can’t take HRT safely—it’s all about finding the right balance for your unique situation.
I’ve heard of different forms of HRT—what are my options?
You’ve got plenty of choices! HRT comes in various forms, like patches, creams, mists, gels, pills, and even vaginal rings. Your doctor will help you choose the best method based on your symptoms and lifestyle.
Can I be on HRT and have an IUD?
Yes, you can! Many women use HRT alongside an IUD. It’s all part of creating a treatment plan that works best for your needs.
I’m currently on semaglutide (Ozempic, Wegovy), can I be on HRT too?
Yes. Using semaglutide or tirzepatide along with HRT is safe as long as you’re under the close supervision of your doctor. In fact, it’s now being proven that the use of HRT and GLP-1s together can increase weight loss by up to 20%.
WTF is happening? Weird stuff explained.
Night sweats are messed up. Here’s what’s really going on (in terms you won’t need to Google).
Usually, during the second part of your cycle, your body temp will rise, letting everyone know you’re ripe for the picking (aka ready for baby making). During perimenopause, we experience a decrease in estrogen which causes our signals to short-circuit and tell your body it’s hot when it’s not.
You can be going along your merry way when your brain sends out a signal to your body: Hey, it’s getting hot in here. Your body reacts accordingly and dumps the heat by dilating blood vessels, pushing hotness out of the body through your skin, and perspiring.
A few seconds or minutes later, your brain says, Oh, wait, my bad, we’re not hot, and you’re body is like, Dude, too late. You’ve lowered your body temperature to beat the heat and are now freezing.
This fun game of “Yes, I am” and “No, I’m not” can persist for years.
But it doesn’t have to. Hormone replacement therapy (HRT) can replenish your estrogen supply and repair any signal short-circuiting. It might take a few tries to get it exactly right for YOUR body, but it can bring relief.
And good news. If you aren’t a candidate for HRT, there are other medications and solutions available to you.
So, while sticking your foot out and buying a fan can offer a temporary skosh of relief, it won’t fix the problem.
Let’s FIX the problem.
Tips worth sharing
If you’re waking up in a pool of your own sweat–ugh–then staying hydrated is just about having a cute IG moment with your Owala; it’s a non-negotiable.
I shoot to get 70 ounces of water daily, and I like my water to do more than just one job, so I add creatine and collagen. Here’s why:
Creatine because:
- ⚡ Helps with muscle strength
- ⚡ Improves cognitive function
- ⚡ Keeps inflammation down to aid muscle recovery
- ⚡ Reduces mental fatigue and may help with mood
Collagen because:
- ✨ Keeps connective tissues like skin, hair, and nails flexible
- ✨ Adds volume and moisture to your skin
- ✨ Improves joint health
- ✨ Helps with gut health and weight management
