NATUROPATHIC DOCTOR IN ONTARIO
Hormone Therapy in Perimenopause
Myths, Benefits, and When to Consider It
Hormone Therapy in Perimenopause
Hormone therapy has long been one of the most misunderstood—and often feared—treatments in women’s health. For women going through perimenopause, it can feel like there’s a wall of conflicting information: Is it safe? Will it increase cancer risk? Is it only for severe symptoms? Shouldn’t I just “ride it out” naturally?
At Sequence Wellness, we believe in informed, individualized care. That means cutting through the noise and looking at the real science behind hormone therapy (HT), as well as considering when and why it may be appropriate.
If you’re in your 40s and experiencing the rollercoaster of perimenopause—mood swings, night sweats, brain fog, heavy periods, or exhaustion—this blog will walk you through the facts, bust the common myths, and help you understand whether hormone therapy could be a helpful part of your wellness strategy.
What Is Hormone Therapy (HT)?
Hormone therapy typically refers to the use of estrogen and sometimes progesterone (and occasionally testosterone) to supplement declining hormone levels in women during perimenopause or menopause.
There are two main types:
- Systemic HT – delivered via pills, patches, gels, or injections; affects the whole body
- Local HT – applied directly to vaginal tissue to support local symptoms like dryness or discomfort
The goal is to restore hormonal balance, reduce symptoms, and protect long-term health—especially brain, bone, and heart health.
The History: Why Women Got Scared
Much of the fear around hormone therapy comes from the Women’s Health Initiative (WHI) study in the early 2000s. This large-scale study reported increased risks of breast cancer, heart disease, and stroke in women using combined hormone therapy (estrogen + synthetic progestin).
The results were widely publicized—but later reevaluated. Key takeaways:
- The study involved older postmenopausal women (average age 63), many of whom had pre-existing health risks
- The type of hormones used (conjugated equine estrogen and synthetic progestin) are not the same as the bioidentical hormones we use today
- Follow-up studies have shown that younger women (in their 40s and 50s) starting HT earlier in the menopausal transition may benefit from protective effects, especially on the heart and brain
Unfortunately, the original headlines caused many women and doctors to avoid hormone therapy altogether—even when it could be helpful.
Benefits of Hormone Therapy in Perimenopause
When used appropriately and under medical supervision, hormone therapy can offer significant relief and long-term support.
1. Symptom Relief
- Reduces hot flashes and night sweats
- Improves sleep quality
- Supports mood and cognitive function
- Reduces vaginal dryness and discomfort during intimacy
- Helps regulate cycles during the perimenopausal transition
2. Bone Health
Estrogen helps protect against bone loss and osteoporosis, which becomes more likely after menopause. Hormone therapy can preserve bone density and reduce fracture risk.
3. Brain Health
Estrogen supports memory, attention, and neurotransmitter balance. Starting HT earlier in the transition may help reduce the risk of dementia and cognitive decline (according to emerging research).
4. Heart Health
In early perimenopause, HT may help maintain healthy cholesterol, blood vessel elasticity, and insulin sensitivity, potentially reducing the risk of heart disease when started at the right time.
When Is the “Right Time” to Start?
The window of opportunity for hormone therapy is usually:
- During perimenopause or early postmenopause (within 10 years of your last period or before age 60)
- When symptoms are significantly impacting your quality of life, and other strategies have not provided sufficient relief
Every woman is different—so we consider your age, symptom profile, personal and family health history, and preferences when discussing options.
Common Myths About Hormone Therapy
❌ “HT causes breast cancer.”
Truth: The risk is small and depends on the type of hormone, duration, and individual risk factors. Estrogen alone does not appear to increase risk, and in some cases, may reduce it.
❌ “You can only take HT after menopause.”
Truth: Many women benefit from hormone therapy during perimenopause, especially if symptoms are intense and impacting function.
❌ “Natural or bioidentical hormones are unsafe or unregulated.”
Truth: Bioidentical hormones are molecularly identical to those made by the body and are often compounded to fit your specific needs. There are also FDA-approved bioidentical options.
❌ “If you’re healthy, you don’t need hormones.”
Truth: Hormone therapy is about optimization and support, not just survival. You deserve to feel well, not just “fine.”
Is Hormone Therapy Right for You?
At Sequence Wellness, we never recommend hormone therapy without:
- Thorough hormone and health assessments
- Review of family history (breast cancer, cardiovascular disease, etc.)
- Discussion of personal values and goals
We also consider alternative options—like herbal support, lifestyle medicine, and nutrient therapy—for women who aren’t ready for HT or don’t meet the criteria.
Monitoring Matters
Hormone therapy isn’t a one-size-fits-all prescription. If we determine HT is right for you, we:
- Start with the lowest effective dose
- Use bioidentical formulations when possible
- Monitor symptoms and lab work regularly
- Adjust dosing based on response, not just numbers
We also ensure you have support in nutrition, stress management, sleep, and exercise—because hormone therapy works best as part of a comprehensive wellness plan.
Bottom Line: Hormone Therapy Is a Tool—Not a Last Resort
You don’t need to suffer through years of disrupted sleep, anxiety, or exhaustion just because “it’s part of the process.” Hormone therapy isn’t about reversing time—it’s about giving your body the support it needs to move through this transition with strength and vitality.
If you’re curious about hormone therapy, or wondering whether it’s right for you, we invite you to book a consultation with Sequence Wellness. We’ll walk you through your options, answer your questions honestly, and create a plan that puts your well-being at the center.
Dr. Sarah Goulding, Naturopathic Doctor
Dr. Sarah Goulding is a licensed naturopathic doctor in Ottawa Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
Dr. Elizabeth Miller, Naturopathic Doctor
Dr. Miller completed her doctor or naturopathic medicine degree at the Canadian College of Naturopathic Medicine, and holds a Master’s and Bachelor’s of science in Human Health and Nutrition from the University of Guelph. Her extensive knowledge of nutrition and her strong foundation in scientific research allows for a very thorough approach to your care. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
She is passionate about teaching holistic health to help women understand their bodies and get to the root cause of their health issues. Her areas of special interest include women’s health, hormonal health, gastrointestinal health, and pediatrics.
Dr. Janna Fung, Naturopathic Doctor
Dr. Janna Fung is a licensed naturopathic doctor with a special interest in dermatology and women’s health. She has a passion for evidence based preventative medicine and strives to empower patients with the knowledge to achieve their optimal health. She understands collaborations is the only way to develop realistic sustainable health/wellness results and strives to develop individualized health goals with patients.