If you’re not sure what the different phases of menopause are let us help clarify.

Perimenopause is the time before menopause when a woman is still having periods, but their hormones are starting to fluctuate.

On average, perimenopause starts in the late 30s or early 40s and can be very subtle, many women don’t even realize they are experiencing perimenopause. It is only when hormones begin to fluctuate enough to cause noticeable symptoms. Every woman’s transition and experiences are different. The most common symptoms are hot flashes, night sweats, weight gain, headaches, fatigue, irregular periods, depression, decreased libido, and vaginal dryness but there are over 30 different symptoms. (see list of symptoms here)

Menopause is a natural biological event that occurs in midlife ending the reproductive years. The ovaries stop releasing eggs and levels of estrogen and progesterone production decline. This causes disruption and an eventual end to menstruation. Surgical removal of the ovaries will cause immediate menopause. Production of other hormones such as testosterone and thyroid function can also start to decline. Once a woman has completed the menopausal transition and has gone 12 months without a period, she is considered postmenopausal.

HRT can help improve your life in many ways. The most popular symptom associated with menopause is hot flashes. However, according to most women, while hot flashes are annoying and uncomfortable, some of the symptoms that affect women the most are, weight gain, low libido, vaginal dryness, insomnia, brain fog, depression, and anxiety. Taking HRT will help maintain a healthy weight, increase energy levels, improve libido, reduce vaginal dryness and pain, eliminate hot flashes and night sweats, improve depression and anxiety, protect your bones, and reduce your risks for heart disease, colon cancer, and Alzheimer’s.

Our bodies need sex hormones: estrogen, progesterone, and testosterone for more than just sex and fertility. We have thousands of hormone receptors in our bodies, hormones are required for them to function properly. When the body stops naturally producing hormones the body stops operating correctly and efficiently.

HRT replaces the deficient levels of hormones in your body. This will allow your body to work correctly and should eliminate the pesky symptoms you are having allowing you to feel better while also providing you preventative benefits lowering your risk of chronic diseases.

Depending on the levels of hormones your body is still naturally producing and the symptoms you are experiencing, a combination of estrogen, progesterone, and testosterone may be prescribed. Your menopause specialist will use both blood work and your symptoms to determine what treatment plan is best for you.

If you have a uterus and take estrogen, you will benefit from also taking micronized progesterone to protect the uterine lining. When you take estrogen without progesterone the lining of the uterus may thicken and increase the risk of uterine cancer. However, taking progesterone negates that risk.

Progesterone is referred to as the pregnancy hormone, it helps build up a lining and prepares the uterus to nourish a fertilized egg. Without a fertilized egg the uterine lining sheds and the cycle repeats. Your body has been producing progesterone all along and has been working to protect the uterus in the same way.

Taking HRT picks up where your body leaves off and keeps your body working efficiently. If you no longer have a uterus, it is optional to take progesterone, some women find symptom-relieving benefits while others do not. Some research shows progesterone can have a calming effect if taken a night and may help with insomnia.

Many medical providers don’t realize what an important role testosterone plays in women’s health, as it is thought of as a male hormone. A woman makes more testosterone than estrogen in her body until menopause. If needed, testosterone replacement added to HRT can be beneficial to improve or maintaining libido, cognitive function, bone density, muscle mass, and energy. It is also beneficial for maintaining collagen and skin thickness.

Generally, there are no significant side effects if levels are kept within a female physiological range. Some side effects may include acne and some minor hair growth on the site application. If the side effects are bothersome, the dosage can be reduced. Numerous studies show testosterone replacement is not only safe but improves the overall well-being of a woman.

Life expectancy has increased over the past century, biologically our bodies have not kept up with our extended life spans due to improved lifestyle changes and medical advancements. As recently as 100 years ago the average life expectancy for a woman was about 50 years old, today it is about 80. With the average age of menopause at 51, women will spend nearly 30 years or a third of their lifetime in post-menopause. Modern western medicine, overall, has not addressed the need to care for women during and after the menopausal transition in life. Thus, leaving women to suffer needlessly.

Studies have found not only does HRT reduce menopausal symptoms and improve how you feel, but it also has live saving and life-extending advantages. Some of the more important benefits of HRT are a reduction in cardiovascular disease, osteoporosis, mental health issues, and dementia.

• Vasomotor symptoms, hot flashes, and night sweats are far more menacing than just making you feel hot and sweaty and cause insomnia, they can cause damage and increase the risk of cardiovascular disease. HRT will improve the elasticity of the arteries to help blood flow. Cardiovascular disease is the number one killer in women.

• Women over the age of fifty begin to lose bone resiliency from the decline of estrogen in their bones and have an increased risk of developing osteoporosis. With osteoporosis, women have a higher risk of bone fractures, particularly hip fractures. Studies show the life expectancy of a woman is reduced, on average, several years after a hip fracture.

• There are estrogen receptors throughout the brain. As estrogen declines in menopause, the brain is starved of the necessary estrogen needed to help brain cells. Estrogen assists with nerve cell growth, and regeneration, improves blood flow and helps prevent cell damage. A drop in estrogen after menopause may increase the risk of dementia, a middle-aged woman has about a 1 in 5 chance of developing Alzheimer’s.

• In addition to estrogen’s importance in keeping the brain healthy, it is also important for your mental health. As with PMS, when your hormones fluctuate or drop in menopause it can affect your mood and how you feel. Hormones play a critical role in brain function. When your hormones are out of balance or depleted your brain’s response system fails to work which can lead to depression or anxiety. Women in perimenopause and menopause have a higher rate of depression and anxiety.

Countless studies have shown HRT reduces cardiovascular disease, decreases bone loss, reduces the risk of dementia, and improves a women’s mental health, just to name a few. The studies indicate that starting estrogen replacement within 10 years of menopause onset is the most beneficial for women and the prevention of disease. Research shows women who take HRT have fewer chronic diseases and can live, on average, several years longer than those who do not. Hormone replacement may not be for every woman but if you are suffering from menopausal symptoms reach out for help. A menopausal specialist can help you determine if HRT is right for you.

The consensus among those who study hormone replacement and over 70 years of data is, hormone replacement therapy is safe for most women. As with any medicine, there are some risks depending on a woman’s age, lifestyle (smoker, extremely overweight), or other underlying health conditions that may exist. This doesn’t necessarily mean you aren’t a candidate for HRT it just means your medical condition needs to be evaluated to determine if the benefits of HRT out way any risks.

There is a lot of contradictory information about hormone replacement therapy (HRT), which can be very confusing and concerning. You may have friends or family that take HRT and praise it from the mountain tops, or you may have Googled HRT and been scared by claims that it causes cancer, blood clots, and strokes.

Let’s clear this conflicting information up.

Until the early 2000’s HRT was a common treatment for women experiencing menopausal symptoms and was well-supported in the medical community. By the 1990s when HRT was at its highest prescription levels there were nearly 50 years of evidence that estrogen replacement was not only safe but had significantly reduced the risks of chronic diseases such as heart disease, bone fractures, colon cancer, and dementia.

In 2002 the medical community and their patients were misinformed and shaken by a highly publicized but misrepresented study of HRT conducted by the Women’s Health Institute (WHI) that incorrectly noted HRT causes breast cancer, heart disease, stroke, and dementia. Not only has this been discredited by leading doctors in the field but is contradicted by the preceding 50 years of data and additional subsequent studies that have shown the WHI report did not report fair and factual information regarding HRT prescribed to healthy menopausal women within 10 years of menopause. In short, the report claimed the women in the study were healthy. The fact is they were not, the study was conducted on a group of post-menopausal women that were either overweight, or already being treated for high blood pressure, and half were current or past smokers, and they were an average age of sixty-three, far beyond the onset of menopause around the age of 51. The represented women were already at high risk for all the chronic diseases the study claimed to cause. *To read more detail about the study click here.

Since the release of the WHI report, many studies have been reviewed to evaluate the adverse effects of the WHI study. After the report was released, millions of women stopped taking hormones for fear of developing breast cancer. Since then, many doctors and scientists have looked at the data and determined thousands, possibly as many as 90,000, women died prematurely because of the elimination of estrogen replacement they were taking. Many of these women died from cardiovascular disease and complications from bone fractures. Research shows HRT helps reduce the risk for both diseases and does not increase the risk of breast cancer. Even the WHI has since clarified its findings that estrogen does not increase the risk.

So, is hormone replacement therapy safe? Yes, the data indicates the benefits of symptom relief and chronic disease prevention far out way the low absolute risks for most women provided you start HRT at the onset of symptoms or within 10 years of menopause.