Menopause Doctor in Ontario
Hormonal issues in menopause and perimenopause can be life-altering. All women transition to menopause, but some women suffer in the process. There are natural menopause treatment options to help balance hormonal health, improve day-to-day symptoms, as well as prevent long-term medical conditions.
Evidence-Based Naturopathic Care for Menopause Hormones Support.
Most insurance plans cover the first 3 visits — we direct bill where possible.
Your return to hormonal stability starts here.
Connect with educated health care professionals who are thoroughly trained in perimenopause, menopause and hormone therapy. They can prescribe so that you are well informed, safe, and confident.
Dr. Elizabeth Miller
Naturopathic Doctor
Dr. Janna Fung
Naturopathic Doctor
Dr. Mariia Tanasyshyn
Naturopathic Doctor
Dr. Sarah Goulding
Naturopathic Doctor
WHAT WE TREAT
What is Menopausal Hormone Therapy?
Estrogen & Progesterone Prescriptions
Menopause Hormone Therapy (MHT), also referred to as Hormone Replacement Therapy (HRT), is a medical treatment used to manage the symptoms of menopause. It works by replacing or supplementing the hormones—primarily estrogen and progesterone—that the body produces in lower amounts during perimenopause and after menopause. Menopause marks the end of a woman’s reproductive years, typically occurring between ages 45 and 55, and it is characterized by the cessation of menstrual cycles and a reduction in hormone production.
MHT is designed to help alleviate common menopausal symptoms such as hot flashes, night sweats, mood changes, sleep disturbances, and vaginal dryness. In addition, it can help prevent long-term health conditions associated with menopause, such as osteoporosis and heart disease, by providing hormonal support.
Why Patients Choose Sequence Wellness for Menopausal Hormone Therapy
Educated & Knowledgeable
Our licensed naturopathic doctors are Menopause Society Certified Practitioners, as well as have extensive training in perimenopausal and menopausal health via the International Society for the Study of Women’s Sexual Health, and other continuing education groups.
More Time
Our practitioners have the luxury of time, and spend 90 minutes in the first visit thoroughly gather information to be sure that the root cause and true diagnosis is determined. We also have plenty of time to answer any of our patient’s questions, so women leave the appointment feeling fully informed and confident about their treatment path.
Personalized, Not Cookie Cutter
We follow the evidence-based guidelines for menopausal hormone therapy, but that also leaves room to make adjustments to the standard basic hormone therapy treatment. Although MHT guidelines state that laboratory testing is not required in order to safely and effectively prescribe hormone therapy in menopause, we feel more comfortable having baseline general health and hormonal testing, as well as periodic serum hormone testing to ensure that we are within the therapeutic range and safety range for these hormonal medications. At times we may suggest more comprehensive functional lab testing to better assess how a woman’s body is processing the hormones (estrogen elimination pathways for example), so that we can support these body systems if needed. We don’t believe that the body systems work in silos, so also fold in sleep support, cortisol management, liver detoxification, gut health and nervous system regulation to be sure that we are both getting the best bang for our buck from the hormone therapy, as well as making sure we are not leaning more on the prescription than we need to.
More Extensive Lab Testing
As stated above, the guidelines for menopausal hormone therapy do not require lab testing before, during or after prescribing hormone therapy. And that is because it is safe and effective without these additional measures. Blood/serum hormonal testing also does not give the full picture of the intracellular hormonal activity. It does however let us know if the woman’s hormonal levels are too high. So we use this lab testing as a safety gauge before administering estrogen therapy. We also often test follicle stimulating hormone (FSH) to determine how far along the perimenopausal journey our patient currently is. We also may test testosterone, adrenal hormones, and general health labs to make sure that all other systems are operating well, otherwise we may have to support those systems before starting the hormone therapy to avoid any temporary side effects. Lab testing is always optional. We give our patients our wish list, and they decide the route they would like to take.
Menopausal Hormone Therapy Available Across Ontario
As we are a virtual clinic, we are able to prescribe hormone therapy to women across Ontario. We will send you to your local Lifelabs or Dynacare for lab testing, and refer you to a local practitioner if a physical exam is required.
Menopause Therapy Quiz
Find out about the different types of hormone therapy, and discover if either are right for you.
IS HORMONE THERAPY RIGHT FOR YOU?
Many people have a lot of uncertainty around hormone therapy due to widespread dissemination of the negative results of some older research, but in fact, newer evidence shows that not only can hormone therapy be safe and symptom reducing in certain populations, but actually reduces some chronic diseases as well.
Take 1 minute to complete this FREE SELF TEST to determine if you are possibly a good candidate for hormone therapy.
Common Hormonal Symptoms of Menopause and Perimenopause
Menopause and perimenopause can bring about a range of symptoms, which may vary in intensity and duration for each woman. Some of the most common symptoms include:
Hot Flashes and Night Sweats
Hot flashes are sudden sensations of intense heat that can cause flushing and sweating. Night sweats are similar but occur during sleep, leading to disrupted sleep patterns.
Mood Swings and Emotional Changes
Fluctuations in hormone levels can contribute to mood swings, irritability, anxiety, depression, and difficulty concentrating. Brain fog is a common symptom that we see in our patients. Brain fog usually improves on its own after the perimenopausal transition, but hormonal balancing (including the use of bioidentical hormones) can greatly improve brain fog during perimenopause.
Vaginal Dryness and Discomfort
Decreased estrogen levels can lead to vaginal dryness, itching, and discomfort during sexual intercourse, which may affect a woman’s quality of life and intimate relationships. This symptom is almost universal in postmenopausal women. There are some natural lubricants that can be helpful, and pelvic physiotherapy also has utility, but the most reliable and effective treatment for this is the use of bioidentical estrogen (topical estriol, in particular).
Sleep Disturbances
Many women experience difficulties with sleep during perimenopause and menopause, including insomnia, waking up frequently during the night, or having trouble falling asleep. Though we have to first ensure that the patient’s nutrition is not a contributing factor (low-calorie and low-protein intake in the evening can contribute to nighttime cortisol spikes, which trigger wakefulness), as well as rule out sleep apnea or a urinary concern, bioidentical progesterone can be very useful for perimenopausal and menopausal insomnia.
Changes in Menstrual Cycle
During perimenopause, menstrual cycles may become irregular, with variations in the length of the cycle or the amount of flow. Eventually, menstruation ceases altogether in menopause.
Changes in Body Composition
Many women experience a 5-10lbs weight gain in the menopausal transition, though from an evolutionary perspective this may be a very healthy adaptation that improves health and fitness overtime, many women find this change unpleasant and unsettling.
Changes in Sexual Function??
Some women may experience a decrease in libido or changes in sexual desire and satisfaction due to hormonal fluctuations and vaginal dryness. However, often these symptoms relate to complex underlying biological interplay, as well as complicated life circumstances. Naturopathic medicine addresses the whole person to reestablish the balanced function required to allow a woman’s sexual desire (be that spontaneous or responsive) to be reignited.
Hormone Supplements In Menopause
Depending on the individual, there are many supplements and herbs that can be appropriate for improving symptoms, especially early into the perimenopausal transition. These can include omega-3, probiotics, DIM, black cohosh, vitex, soy isoflavones, calcium, magnesium, vitamin D, vitamin K, and many more. It’s best to see your naturopathic doctor to get a personalized list of supplements that are right for you. Often, new patients arrive already taking handfuls of supplements, and part of what we do is to teach them how to get many of these nutrients through their diet and only take the supplements that are needed.
Bioidentical Hormones In Menopause
There are two ways to use bioidentical hormones:
- To top up and balance fluctuating hormones
- To replace declining hormones
For this reason, it is called “Menopausal Hormone Therapy,” and the specific dosing and ratio not only varies per patient but also varies depending on where the woman is in her hormonal transition. Licensed naturopathic doctors prescribe estradiol, estriol, and progesterone, and we work with nurse practitioners when patients need testosterone and DHEA. It can be dispensed as a patch, a gel, a cream, or a capsule. There is a complicated history about the safety and efficacy of hormone replacement therapy, but the takeaway is that for most women, as long as they have been properly screened and the prescription is the right dose and route of administration, it is safe for up to 5 years and potentially for up to 10 years. Like all medical choices, it requires a thorough risk-benefit analysis of all the variables that pertain specifically to you. Our naturopathic doctors take the time to do a thorough screening process, provide you with education about the research, and give you the time you need to ask all your questions so that you feel fully informed and comfortable about your decision.
How Menopause Hormone Therapy Works
Menopause leads to a natural decline in reproductive hormones, often with estrogen fluctuating wildly during the transition. This change in estrogen can result in a range of symptoms, including hot flashes, night sweats, mood swings, vaginal dryness, and reduced bone density. MHT works by replenishing and balancing hormone levels to alleviate these symptoms and help maintain hormonal equilibrium.
For women with intact uteruses, progesterone is added to the therapy to eliminate the risk of endometrial hyperplasia (overgrowth of the uterine lining), which can lead to cancer if left untreated. MHT is typically administered through pills, patches, gels, creams, or vaginal inserts, and the delivery method can be tailored based on the patient’s specific needs, preferences and risk factors. Oral estrogen is absolutely contraindicated, and estrogen is instead applied topically as a gel, cream, or patch. Progesterone is prescribed vaginally or orally. Progesterone hormone therapy alone may be prescribed for women with symptoms of heavy periods, anxiety and insomnia.
Risks & Benefits of Menopausal Hormone Therapy
Benefits of MHT
Short-Term Benefits of MHT:
Relief from Vasomotor Symptoms: The most common and bothersome symptoms of menopause are hot flashes and night sweats. MHT is highly effective in reducing the frequency and severity of these symptoms.
Improved Sleep: Many women experience sleep disturbances due to hot flashes and night sweats. MHT can improve sleep quality by reducing these symptoms.
Enhanced Mood: Hormonal fluctuations during menopause can contribute to mood swings, anxiety, and depression. MHT helps stabilize mood by restoring hormonal balance.
Improved Vaginal Health: Estrogen therapy can improve vaginal dryness, itching, and discomfort, as well as reduce urinary issues associated with menopause.
Better Sexual Function: By alleviating vaginal dryness and enhancing libido, MHT can help improve sexual satisfaction.
Long-Term Benefits of MHT:
Prevention of Osteoporosis: Estrogen helps maintain bone density. Postmenopausal women are at increased risk of osteoporosis due to the loss of estrogen. MHT can help prevent bone loss and reduce the risk of fractures.
Cardiovascular Health: Estrogen has a protective effect on the cardiovascular system, and MHT can help reduce the risk of heart disease, particularly if started soon after menopause.
Skin and Hair Health: Estrogen helps maintain skin elasticity and hair thickness, so MHT may reduce the appearance of skin aging and hair thinning.
Risks of MHT
While MHT offers significant benefits, it also carries potential risks that must be considered before starting treatment. It is important for each woman to consult with her healthcare provider to weigh the risks and benefits based on her medical history and individual health needs.
1. Breast Cancer Risk
One of the most discussed risks of MHT is its potential association with breast cancer. Research has shown that combined estrogen and progesterone therapy (especially oral forms) may slightly increase the risk of breast cancer, particularly with long-term use. However, the risk appears to be lower for women who use bioidentical hormones, for those who start MHT closer to the time of menopause, and when estrogen is administered topically. There is no current evidence that topical estradiol and oral or vaginal micronized progesterone increases the risk of breast cancer, even if taken for longer than 5 years.
According to the British Menopause Society (BMS), the breast cancer risk is greatest for women who use combined hormone therapy for more than five years. The Menopause Society in the U.S. similarly notes that the risk is lower for women using hormone therapy for a shorter duration, and the decision to use MHT should be individualized. It’s important to note that the research from which these recommendations are made use MPA which is a progestin, not bioidentical progesterone.
Current evidence suggests that for the first five years of use, combining estradiol with micronized progesterone (as opposed to synthetic progestins) is not associated with an increased risk of breast cancer. This is supported by data from the large French E3N-EPIC cohort study, which found no increased risk with estrogen plus micronized progesterone, in contrast to a significantly elevated risk with estrogen plus synthetic progestins (Fournier et al., International Journal of Cancer, 2005). An international expert panel systematic review reached the same conclusion for treatment durations up to five years (Stute, Wildt & Neulen, Climacteric, 2018). Importantly, the well-known Women’s Health Initiative study — often cited as evidence of HRT-related breast cancer risk — tested only oral conjugated equine estrogens with a synthetic progestin, and its authors themselves noted the results may not apply to transdermal estradiol combined with progesterone.
Beyond five years of use, the evidence becomes more limited, as most long-term studies simply haven’t followed patients using this specific combination for that long — so while there’s no clear signal of increased risk, the picture beyond five years is less certain rather than definitively reassuring. This underscores the importance of individualized, ongoing risk-benefit conversations with your provider, regardless of which type of hormone therapy you use.
2. Blood Clots and Stroke
Oral forms of estrogen therapy can increase the risk of venous thromboembolism (blood clots) and stroke, particularly in women who are older, obese, or have a history of blood clotting disorders. Transdermal estrogen (delivered through patches or gels) is generally considered safer in this regard, as it does not carry the same increased risk of blood clots.
The Menopause Society and BMS both recommend careful screening for these risks, particularly in women who are older or have risk factors for cardiovascular disease or clotting disorders. No evidence-based, well informed licensed health care provider will prescribe oral estrogen for menopausal hormone therapy at this point.
3. Endometrial Cancer
For women who have not had a hysterectomy, estrogen therapy alone can increase the risk of endometrial cancer (cancer of the uterine lining). This is why progesterone is always added to MHT in women with intact uteri to protect against this risk.
Studies have shown that the addition of progesterone eliminates this risk, which is why combined hormone therapy is recommended for most women who have a uterus.
Type of Menopausal Hormone Therapy
Type of Menopausal Hormone Therapy
Estrogen Only Hormone Therapy. Topical estrogen can be used for women without a uterus (with history of hysterectomy), as progesterone is not needed to protect the uterus from endometrial hyperplasia. Estrogen only therapy tends to improve hot flashes, brain fog, mood, body composition, sleep, reduce the risk of cardiovascular disease and osteoporosis.
Estrogen Only Hormone Therapy. Topical estrogen can be used for women without a uterus (with history of hysterectomy), as progesterone is not needed to protect the uterus from endometrial hyperplasia. Estrogen only therapy tends to improve hot flashes, brain fog, mood, body composition, sleep, reduce the risk of cardiovascular disease and osteoporosis.
Progesterone Only Hormone Therapy. Oral or vaginal progesterone can be given in perimenopause to boost a faltering luteal phase progesterone deficiency. This can be helpful for women who have pre-menstrual spotting, very heavy periods, and pre-menstrual anxiety or insomnia. Topical progesterone is not a great options because serum levels tend to be low and unpredictable. The guidelines informed by research supports both oral and vaginal progesterone.
Progesterone Only Hormone Therapy. Oral or vaginal progesterone can be given in perimenopause to boost a faltering luteal phase progesterone deficiency. This can be helpful for women who have pre-menstrual spotting, very heavy periods, and pre-menstrual anxiety or insomnia. Topical progesterone is not a great options because serum levels tend to be low and unpredictable. The guidelines informed by research supports both oral and vaginal progesterone.
Combined Estrogen & Progesterone Therapy. This is the most common form of hormone therapy given in menopause. A topical estradiol gel or patch, paired with oral or vaginal progesterone. This gives the woman the benefits of both hormones, and keeps her risks low as well. The estrogen is taken continuously, and the progesterone may be taken continously as well if a woman is no longer cycling, or it will be taken in the luteal phase only. The progesterone component of this equation can be a progestin IUD (most commonly Mirena), allowing the ND to be able to prescribe topical estrogen only.
Combined Estrogen & Progesterone Therapy. This is the most common form of hormone therapy given in menopause. A topical estradiol gel or patch, paired with oral or vaginal progesterone. This gives the woman the benefits of both hormones, and keeps her risks low as well. The estrogen is taken continuously, and the progesterone may be taken continously as well if a woman is no longer cycling, or it will be taken in the luteal phase only. The progesterone component of this equation can be a progestin IUD (most commonly Mirena), allowing the ND to be able to prescribe topical estrogen only.
Vaginal Estrogen. Genitourinary Syndrome of Menopause is a near universal concern for menopausal women, and symptoms can even start in the menopausal period. These symptoms of vaginal dryness, pain with intercourse, recurrent UTIs, and more, are very effectively improved with vaginal and vulvar application of estradiol.
Vaginal Estrogen. Genitourinary Syndrome of Menopause is a near universal concern for menopausal women, and symptoms can even start in the menopausal period. These symptoms of vaginal dryness, pain with intercourse, recurrent UTIs, and more, are very effectively improved with vaginal and vulvar application of estradiol.
Vaginal DHEA. Genitourinary Syndrome of Menopause can also be improved with the use of vaginal DHEA. In our patients who are not fully improved by vaginal estradiol (which is rare), we work collaboratively with nurse practitioners to give our patients access to vaginal DHEA prescriptions like Intrarosa.
Vaginal DHEA. Genitourinary Syndrome of Menopause can also be improved with the use of vaginal DHEA. In our patients who are not fully improved by vaginal estradiol (which is rare), we work collaboratively with nurse practitioners to give our patients access to vaginal DHEA prescriptions like Intrarosa.
Topical Testosterone. Though many perimenopausal and menopausal women seek out testosterone to boost energy, the evidence only support testosterone therapy in women who are diagnosed with Hypoactive Sexual Desire Disorder (aka low libido). In our practice we find focusing on repleting nutrient deficiencies, improving sleep quality, and optimizing stress resilience to be more effective for energy, but work collaboratively with nurse practitioners to access topical testosterone for our patients when appropriate.
Topical Testosterone. Though many perimenopausal and menopausal women seek out testosterone to boost energy, the evidence only support testosterone therapy in women who are diagnosed with Hypoactive Sexual Desire Disorder (aka low libido). In our practice we find focusing on repleting nutrient deficiencies, improving sleep quality, and optimizing stress resilience to be more effective for energy, but work collaboratively with nurse practitioners to access topical testosterone for our patients when appropriate.
What other conditions do we treat? Check out our hormonal health hub for educational content about various health concerns.
What's the Difference Between Menopause and Perimenopause?
What is Menopause?
Menopause is a natural biological process that marks the end of menstruation and fertility in a woman’s life. It typically occurs in the late 40s to early 50s (average age of 51), although it can vary for each individual (the range is anywhere from the 30s for premature ovarian failure to the 60s). During menopause, the ovaries gradually produce less estrogen and progesterone, leading to the cessation of menstrual cycles.
It is when the ovaries close up shop. They have done their part, and now they are entering retirement. Very few mammals experience menopause, and there is a theory that this is an evolutionary strategy to improve intergenerational survival. When one door closes, another door opens. Stepping into the menopausal phase of life can be a beautiful, liberating, and nourishing experience. However, there are some physical and emotional symptoms that may make this process challenging for some. Getting the right assessment and care to ensure that you are feeling your best at this phase of life is not only important for today and tomorrow but also for setting you up for a healthy elderly phase as well.
What is Perimenopause?
Perimenopause is the transitional phase that precedes menopause. It can start several years before menopause and is characterized by hormonal fluctuations. During perimenopause, women may experience irregular periods, as well as the onset of various menopausal symptoms.
Just as the turning on of ovarian function is not always a smooth process (i.e., turbulent teenage years), the ovaries tend to spit and sputter on their way out as well. It is not always a smooth linear decline to menopause. Once women start to miss ovulations, there are step-change decreases in progesterone levels, and it is the scheduled periodic increase and subsequent decrease in progesterone that keeps estrogen levels in check. So, during the transition to no ovulations and no periods, there is often a phase of unpredictability in menses, as well as in mood, sleep, energy, breast tenderness, and many more symptoms that can occur.
Clinical Intake
The first visit with one of our naturopathic doctors is up to 90 mins! This is so long because you are complicated and it usually takes that much time to hear your whole story. We need to ask you about your sleep, energy, mood, food choices, digestion, exercise, stress, etc. We need to take the time to look into all of the nooks and crannies and not miss a detail, as so often there is one tiny clue that really pulls the whole case together. Often what women describe as a “hormonal” concern, may actually relate to something else. We don’t just want to be the hammer that sees everything as a nail. We objectively determine the root cause of your concern.
Lab Testing
Symptoms alone are often not enough to guide a proper treatment plan. Having a good look “under the hood” by testing either the blood, urine or saliva for estrogen, progesterone, testosterone, DHEA and cortisol, among other labs can be invaluable for determining the root cause of a woman’s concerns. We also need to rule out any other non-hormonal issue, to ensure that your foundations of health are well set up. This includes looking at your iron, B12, vitamin D levels, thyroid, cholesterol, liver and kidney markers, inflammation, blood sugar and insulin, etc. We also often draw from data collected by wearable medical devices and fitness trackers (like continuous glucose monitors, Oura rings, Apple watches, Fitbits, Garmins, etc). The more data we get, the more precise and effective the treatment can be.
Diagnosis
Naturopathic doctors are some of the few regulated health care providers in Ontario that are legally capable of diagnosis. Diagnosis is a protected act and only entrusted to highly trained medical professionals regulated by governing bodies that ensure the safety of the public. If everything lines up, and everything else has been ruled out or treated, then we can proceed with prescribing hormone therapy at the end of the second visit.
Treatment
A Naturopathic Doctor works with you to create a strategy for improving diet and reducing stress, and we also create a plan to level the hormonal playing field often using herbs, acupuncture, supplements, and hormone therapy. Risk calculators are used to quantify your risks of breast cancer, cardiovascular disease and osteoporosis, to find the hormonal support that best suits your needs. We then follow-up 3 months after the initial prescription, and then on-going every 6 months to ensure that the hormonal prescription is still effective and appropriate for your case.
Getting started:
Comprehensive Evaluation: Assessing Hormonal Health and Well-being
Diagnosis of menopause is actually based solely on the absence of a period for 12 or more months. However, laboratory testing is important to assess your overall health and determine which intervention may be safest and most effective for you.
Lab Tests in Menopause and Perimenopause
General health testing: CBC, iron panel, CRP (inflammation), B12, vitamin D, fasting insulin, HbA1C, cholesterol, liver enzymes, kidney panel, thyroid, and urinalysis. If you have a family history of heart disease or an issue with methylation, we may also test your homocysteine, and if you have a personal history of high cholesterol, we may run an LDL particle test.
Hormone Panel Testing: Unveiling Hormonal Imbalances
Testing your estradiol is important, as some women who have not had a period in many months can still have medium or high levels of circulating estrogen. Before we feel comfortable prescribing bioidentical hormones, we need to know that the levels are low and it is safe to do so. We may also add in progesterone, prolactin, testosterone, and DHEA if appropriate. FSH rises in menopause, so we will test this as a marker of ovarian function.
Public Health Screenings in Menopause: Assessing Overall Health
It is particularly important to stay up to date on health screenings once you reach menopause. In Ontario, our public health system is excellent at keeping individuals (even those without a family doctor) informed about when they are due for their updated tests.
- Bone mass density testing
- Colon cancer screening
- Breast cancer screening
- Cervical cancer screening
It’s also important to stay up to date on your vision and hearing tests, as well as blood pressure testing (which can be done at your local pharmacy).
Ready to check under the hood? Book with one of our naturopathic doctors to get a thorough assessment of your digestive health
Current Research/Guidelines on Menopausal Hormone Therapy
The British Menopause Society (BMS) and The Menopause Society (USA) provide evidence-based guidelines for the use of MHT. Both organizations emphasize that the decision to use hormone therapy should be individualized and made after a thorough discussion of the risks and benefits with a healthcare provider.
Key Points from the British Menopause Society (BMS) and NICE Guidelines:
MHT is considered safe for most women under the age of 60 or within 10 years of menopause onset. The risks associated with hormone therapy increase with age and time since menopause.
For women with symptoms of menopause, MHT remains the most effective treatment for hot flashes, night sweats, and vaginal dryness.
Key Recommendations from the Menopause Society:
Women should receive personalized counseling regarding MHT, including a review of their individual health history, family medical history, and risk factors.
Transdermal and low-dose therapies are preferred for women who need estrogen but wish to minimize risks like blood clots or stroke.
Women who choose MHT should aim for the shortest duration necessary to manage symptoms, and periodic reassessment is recommended.
Menopausal Hormone Therapy Links & Resources
The Details Of Bioidentical Hormones | The Process
The Benefits of Menopausal Hormone Therapy: Short and Long-Term Advantages
3 Things You Need To Know About Hormone Therapy In Menopause
FACTSHEETS: From the Newson Menopause Society
Breast Cancer Risk in Hormone Therapy
HRT and breast cancer: overall risks and benefits explained | British Menopause Society
Hormone Therapy: Understanding the Risks and Benefits | Menopause Society
FAQ
Will I get prescribed hormones in the first visit?
Hormone therapy is only prescribed on the first visits for women who have been referred to us by their pelvic physiotherapist for vaginal estrogen. For these patients we can do a quick screening protocol and get the ball moving right away. For women seeking out systemic hormonal therapy, we’ll have to do a more extensive assessment, which often includes lab testing, and the hormone therapy is prescribed at the second visit.
How does lab monitoring fit into ongoing care?
Though lab testing is not required to prescribe hormone therapy, we often do a baseline serum estradiol and FSH (along side any other appropriate general health tests) to get a better sense of how far along the perimenopausal transition our patient is. We are more hesitant to prescribe estrogen if she is already struggling to eliminate the fluctuant levels of hormone that she already has. If her levels are high, it doesn’t mean the hormone therapy is off the table (we will still prescribe based on her symptoms), but we will add in more detoxification support so that he system can most benefit from the prescription.
Should I try menopausal hormone therapy?
Menopause Hormone Therapy remains a cornerstone in the management of menopause symptoms and the prevention of long-term health risks, such as osteoporosis and cardiovascular disease. However, its use must be carefully tailored to the individual, considering the potential risks, including breast cancer, blood clots, and cardiovascular issues.
Guidelines from the British Menopause Society (BMS) and The Menopause Society emphasize a personalized, patient-centered approach. Women should be thoroughly evaluated, and any decision to start MHT should involve a discussion of both the potential benefits and risks, along with the consideration of alternative treatments, lifestyle modifications, and natural therapies.
By staying informed about the latest research and medical standards, women can make empowered decisions about managing menopause and improving their quality of life during this significant life transition.
We Welcome All Humans
At Sequence Wellness, we are committed to providing inclusive, respectful, and compassionate care. We welcome people of all races, ethnicities, ages, abilities, religions, sexual orientations, gender identities, and gender expressions. Your health, dignity, and lived experience matter here.
Land Acknowledgement
We respectfully acknowledge that our clinic operates on the traditional, unceded territory of the Algonquin Anishnaabeg People. We are deeply grateful for the opportunity to live and work on this land.
