How Hormone Replacement Therapy (HRT) Can Be Like Dating: Finding Your Perfect Fit

What Is HRT and Why Does It Matter?

Hormone Replacement Therapy (HRT) is a treatment used to relieve symptoms of menopause by supplementing the body with estrogen, progesterone, or both. For many women, HRT alleviates hot flashes, night sweats, mood changes, and other symptoms, while also offering potential protection for bone and heart health. With so many options and mixed messages, it’s important to have accurate, up-to-date information to make the best choice for your health.

The 2002 Women’s Health Initiative Study

The conversation around HRT changed dramatically after the 2002 Women’s Health Initiative (WHI) study. The initial findings suggested that HRT increased risks of breast cancer and heart disease, leading to widespread fear and a significant decline in HRT use. However, the study had several key flaws. Most notably, the average participant was 62 years old—well beyond the optimal window for starting HRT, which is before age 60 or within 10 years of menopause onset. Later analysis showed that starting HRT earlier can offer heart protection and does not increase breast cancer risk for most women. In addition, the WHI used a specific type of HRT (conjugated equine estrogen and medroxyprogesterone acetate, known commercially as Prempro), which is different from many modern, bioidentical hormone options.

Types of HRT: Finding the Right Fit

Just as everyone’s experience of menopause is unique, so is the search for the right HRT. Today’s hormone therapies are available in several forms, allowing women to find the best match for their needs and lifestyles:

• Pills: Oral estrogen and combination therapies are convenient, but may not be suitable for women with digestive or liver issues.
• Patches: Transdermal patches deliver estrogen directly through the skin, bypassing the liver and offering steady hormone levels. They’re changed once or twice a week.
• Gels and Creams: These topical forms also avoid the liver and can be effective, but require time to absorb and may rub off if not fully dried.
• Vaginal Preparations: Creams, tablets, and rings inserted vaginally are especially helpful for symptoms like dryness and discomfort during intercourse, offering targeted relief with minimal systemic absorption.

Many newer HRT products use bioidentical hormones, such as 17β-estradiol derived from plant sources like yams, which closely mimic the body’s natural estrogen.

Personal Journey

My own experience with menopause began in my mid-40s, though I was not diagnosed until a decade later. Symptoms like heart palpitations and feeling bloated and inflamed. I told my family physician that the skin on my legs hurt, and yes you guessed it he told me I need to work out more and change my diet. Dietary changes offered little relief, and it was only through my own research that I discovered I was already postmenopausal at 56. Fortunately, I began HRT within the recommended window—before age 60 and within 10 years of menopause onset. While my provider suggested I could only stay on HRT until age 60, recent guidelines suggest that the duration of therapy should be individualized, with many women benefiting from longer-term use under medical supervision. I am grateful for the benefits I’ve experienced and want others to have the information needed to advocate for themselves.

Be Your Own Advocate

If you’re considering HRT, it’s important to make decisions based on the latest research and personalized guidance. HRT is generally safe and can offer meaningful benefits. The key is to find the type and delivery method that works best for you, and to have ongoing conversations with your provider and with us here. This is a safe place to help with your menopause journey.

Don’t let outdated studies or myths dictate your choices—learn your options, understand the evidence, and advocate for your well-being.

 Written by:

 Marianne Krammes,

Coach