Here at Laura Cipullo Whole Nutrition + Yoga we pride ourselves in our specialization in hormonal health. We believe the endocrine system is so integral to understanding overall health and informs the nutritional approaches we explore with our clients.
If you’ve been following along, we’ve been diving deep into perimenopause and menopause and the hormone changes that occur during this period of life.
Catch up on some of our previous blog posts on the topic:
- Menopause, Estrogen, and its Direct Relationship to Insulin Resistance
- Exercise and Menopause
- Bone Density and Menopause Explained
- 5 Strategies to Reducing Hot Flashes
In this blog, we wanted to discuss hormone therapy, or sometimes referred to as menopause hormone therapy.
To clarify, the terminology is no longer hormonal replacement therapy (HRT) – that is reserved for special cases. HRT is for full hormone replacement therapy. Whereas in menopause, most of the time when we discuss hormone therapy, we are referring to hormone therapy (HT) or menopause hormone therapy (MHT).
Laura and I recently had the pleasure of speaking with Dr. Anna Barbieri on menopause, hormone therapy, our current understandings, and future directions.
We are so excited to feature highlights and learnings from this conversation with you all!
Stay tuned for the episode! The full conversation will be available to stream on our podcast, Eat Kale and Cupcakes.
In the meantime, catch up with Eat Kale and Cupcakes here. Please consider giving the show a rating and a follow. We are grateful for your support.
A brief, practical guide to Menopause Hormone Therapy (MHT): What to know in advance of this exciting episode
Menopause hormone therapy is one option for managing menopausal symptoms by replacing some of the estrogen, sometimes along with progesterone and even testosterone, that naturally declines during menopause.
Current clinical guidance is informed by groups such as the The North American Menopause Society and decades of data from large studies including the Women’s Health Initiative.
MHT may be effective for:
- hot flashes and night sweats
- sleep disruption related to vasomotor symptoms
- vaginal and urinary symptoms of menopause
- prevention of bone loss in appropriate patients
What it may include
- Estrogen therapy (for symptom relief)
- Estrogen + progestogen if a person still has a uterus (to protect the endometrium)
MHT can be given orally, transdermally (patch/gel/spray), or vaginally, depending on the goal of treatment.
Is it safe?
For many people, MHT can be considered safe and effective when started in early menopause (generally within about 10 years of the final menstrual period and before age 60), provided there are no major contraindications.
Risk depends on:
- type of hormones used,
- dose and route (oral vs. transdermal),
- length of use,
- and individual health history. Including age, underlying risk factors ; hormone sensitive breast cancer.
What we discussed with Dr. Barbieri is the idea of a “spectrum of risk” and the importance of a nuanced conversation on the possible benefits and risks.
What we learned from our conversation is that hormone therapy is very nuanced! As with our approach to food and other medications, there is no one-size-fits-all approach. This is why MHT decisions need to always be individualized.
MHT can meaningfully improve:
- sleep quality,
- fatigue,
- joint discomfort,
- and thermoregulation
When these symptoms improve, clients may also find it easier to:
- eat more consistently,
- engage in movement,
- and sustain behavior-based nutrition goals.
In other words, hormone therapy does not replace nutrition care, but it can remove important physiological barriers that interfere with self-care.
For appropriate clients, MHT can be an important part of comprehensive, whole-person menopause care alongside nutrition, movement, sleep, and stress support.
We are so excited to share this conversation with you.
Stay tuned for more on hormone therapy.
Again, catch up with Eat Kale and Cupcakes here.
References:
Faubion SS, Crandall CJ, Davis L, et al. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. doi:10.1097/GME.0000000000002028.
Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013;310(13):1353-1368. doi:10.1001/jama.2013.278040
