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New study finds the benefits of utilizing hormone therapy to support menopausal symptoms, outweighs the risks.

It has been well documented that women going through hormonal changes can cycle through a "variety show" of symptoms - many of which are not traditionally recognized. Things like burning tongue, and electric, or tingling skin have fluctuating hormones to blame just as much as the typically and culturally accepted hot flashes, insomnia, night sweats, and irritability. For nearly 2 decades, supplementing with hormone replacement therapy (HRT) was considered taboo due to the misguided findings of the initial Women's Initiative Study which found that the risks of HRT did not outweigh the benefits of its use. Women enrolled in the study on HRT were found to have higher rates of breast cancer, stroke, and osteoporosis. However, it is now known that estrogen therapy alone in the absence of progesterone, along with the form of estrogen therapy that was being utilized in the study plays a role in preventing these risk factors.

Woman applying bioidentical hormone cream

Another flaw in the study was that the majority of women in the study were well over their 60's. The new study published in the JAMA medical journal, sheds light on the fact that although HRT is not recommended to prevent cardiovascular disease, dementia, or other chronic diseases, it can be used to support vasomotor and other menopausal symptoms. Utilizing hormone therapy within the first decade of the onset of menopause indicates more benefits. The form and delivery mechanisms of the hormones should also be considered. It is important to implement the balanced use of both progesterone and estrogen, not just estrogen alone has often been the case. Additionally, the use of medroxyprogesterone acetate - is problematic, and has been linked with breast cancer. Utilizing low doses of bioidentical hormones - meaning hormones with the same molecular structure as our own body, produce successful results without side effects. Oral micronized progesterone and creams containing low doses of bioidentical estrogens can be used together to keep everything in balance. Another benefit of utilizing estrogen cream instead of oral estrogen is that it avoids the need to be processed through the liver. Avoiding this 'first pass' effect, as it is known, has been shown to lower risks for clots and pulmonary embolism.

older woman using hormone replacement therapy and feeling great

Although this particular study did not recommend HRT as a preventative measure for chronic disease, cardiovascular health, bone loss or dementia, there are many ongoing studies that are in fact showing promise in that exact arena. Along with the Early Versus Late Intervention Trial, the WHI showed that early (between 5-10 years of menopausal onset) use of HRT can in fact be cardioprotective, as well has neuroprotective. Subsequent studies have shown that, hormone therapy in fact improves bone mineral density, and reduces fracture risk in women both with and without osteoporosis. One study also indicated that "low-dose and transdermal hormone therapy are less likely associated with the adverse effects of breast cancer, endometrial hyperplasia, coronary artery disease (CAD), and venous thromboembolism (VTE) previously observed in standard-dose oral HT regimens."

However beneficial the use of hormone therapy to support menopausal symptom can be, it is absolutely vital to optimize the body before starting them. Perimenopausal symptoms can begin around mid-30s. When these, or menopausal symptoms begin, it is a very delicate and time sensitive period of a woman's life - and often a time when traditional medical model offers zero solutions, considers these symptoms to be "normal" or simply blow off the complaints that are presented by patients and instead offer women anti-anxiety or depression medications. In reality, there are many pathways that need optimization during this time in order to ensure graceful aging. A women's metabolic health and immune health goes through major changes as her hormones shift. There are also major changes that occur in the brain when hormonal changes begin to happen - therefore working with a Functional Medicine Practitioner can be useful to support the appropriate dietary approach, thyroid optimization, gut health, exercise efficiency, weight loss, and potential continuous glucose monitoring. Functional Medicine can bridge the gap that most women experience between their childbearing years and menopause. Soul Minded Integrative Medicine can help you navigate your health journey and support aging with vitality, confidence and grace. Schedule a free Discovery Call today to learn more.


  1. Levin VA, Jiang X, Kagan R. Estrogen therapy for osteoporosis in the modern era. Osteoporos Int. 2018 May;29(5):1049-1055. doi: 10.1007/s00198-018-4414-z. Epub 2018 Mar 8. PMID: 29520604.

  2. Naftolin F, Friedenthal J, Nachtigall R, Nachtigall L. Cardiovascular health and the menopausal woman: the role of estrogen and when to begin and end hormone treatment. F1000Res. 2019 Sep 3;8:F1000 Faculty Rev-1576. doi: 10.12688/f1000research.15548.1. PMID: 31543950; PMCID: PMC6733383.

  3. Ashraf MS, Vongpatanasin W. Estrogen and hypertension. Curr Hypertens Rep. 2006 Oct;8(5):368-76. doi: 10.1007/s11906-006-0080-1. PMID: 16965722.

  4. Levin VA, Jiang X, Kagan R. Estrogen therapy for osteoporosis in the modern era. Osteoporos Int. 2018 May;29(5):1049-1055. doi: 10.1007/s00198-018-4414-z. Epub 2018 Mar 8. PMID: 29520604.

  5. Farzaneh S, Zarghi A. Estrogen Receptor Ligands: A Review (2013-2015). Sci Pharm. 2016 Apr 13;84(3):409-427. doi: 10.3390/scipharm84030409. PMID: 28117309; PMCID: PMC5064234.

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