If you’ve ever wondered whether hormone replacement therapy (HRT) is right for you in menopause and beyond, my recent conversation on the Wellness Your Way podcast is a great place to start.
Host Dr. Megan Lyons shared that she’s been approached by countless people wanting to discuss HRT, but she waited to feature this topic until she found someone with decades of hands-on clinical experience, a deep dive into the research, and a passion for helping women navigate this stage of life with clarity and confidence.
It was a pleasure to join her for this episode. Together we explored the questions women ask most about HRT, clearing up confusion and offering practical insights to help you make decisions with confidence.
What Are Bioidentical Hormones?
Estradiol is a bioidentical estrogen. I think it’s really important that women understand what bioidentical is and what it isn’t.
Bioidentical is short for biologically identical, and it just means that the chemical structure of that thing is exactly the same as what your body makes. Women have produced estradiol throughout their lives, and that’s what we’re giving back with bioidentical hormones.
Yes, they are manufactured by pharmaceutical companies, but they are different from the synthetic estrogens found in birth control pills. The key distinction is that bioidenticals match your body’s own chemistry.
Estrogen in Birth Control Pills vs. Estrogen in Patches
When talking about hormone therapy, another question women raise is: Does it cause blood clots?
People know that the birth control pill that has estrogen has an increased risk of blood clots, so they figure estrogen, estrogen, all the same. Not true. They’re not all the same.
It has to do with the type of estrogen. So the estrogen in a birth control pill is synthetic, and the estrogen dose in a birth control pill is not high, but much higher than in postmenopausal HRT.
So yes, birth control pills that contain estrogen do increase the risk of blood clots. (And the best way to not get a blood clot if you’re on the pill is to not smoke.)
Hormone therapy, on the other hand, used to be given in pill form too, and any oral estrogen does slightly raise clotting risk. But that’s not how we do it anymore.
When Is the Right Time To Start HRT?
Estrogen receptors are found in nearly every organ in the body, from the brain to the bones. That’s why the drop in estrogen during menopause can affect so many systems at once.
One critical example is bone health. The moment estrogen production stops, bone mineral density begins to decline. The most intense drop happens in the first five years after menopause. This is why experts recommend that if you’re considering HRT, starting within that five-year window delivers the greatest protective benefits for bone strength.
But my patients ask me all the time: How long to stay on it?
Medical opinion has shifted over the years. Once upon a time, doctors said five years max. Then it became, well, maybe just stay on for 10 years.
Now, the thinking is different, as there’s more research and long-term users are being studied more closely. The studies show that women who’ve been on HRT long-term have a lower rate of cancer.
Have more questions about using HRT in menopause?
📅 Book a free 15-minute call with me, and I’d be happy to help you navigate the world of hormone therapy and manage your health at any age.
Disclaimer: This information is for educational purposes only and is not a substitute for medical advice. Always consult your doctor before making any health decisions.