NATUROPATHIC DOCTOR IN ONTARIO
The Benefits of Menopausal Hormone Therapy: Short and Long-Term Advantages
Advantages for Considering Bioidentical Hormones
Benefits of Hormone Therapy in Menopause
Menopausal hormone therapy (MHT), commonly known as hormone replacement therapy (HRT), is one of the most effective treatments for managing the symptoms associated with menopause. While there have been concerns about its risks, especially regarding long-term use, substantial evidence supports its benefits when used appropriately. This blog will discuss both the short-term and long-term advantages of MHT, helping women make informed decisions about their treatment options.
What is Menopausal Hormone Therapy?
MHT involves supplementing the body with estrogen, progesterone, or a combination of these hormones to alleviate symptoms caused by the natural decline in hormone levels during menopause. It’s particularly effective for symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness. Different forms of MHT include oral tablets, patches, gels, and vaginal creams or rings, each with its specific benefits and risks depending on individual needs and medical history.
Short-Term Benefits of Menopausal Hormone Therapy
1. Relief from Vasomotor Symptoms (Hot Flashes and Night Sweats)
One of the most immediate and significant benefits of MHT is its ability to reduce the frequency and severity of hot flashes and night sweats. For many women, these vasomotor symptoms are the most distressing aspect of menopause, interfering with daily activities and disrupting sleep. Hormone therapy effectively alleviates these symptoms by stabilizing the body’s thermoregulatory centers in the brain, helping to maintain a more consistent core temperature.
2. Improved Sleep Quality
Hormone therapy can improve sleep by addressing two primary causes of insomnia in menopause: vasomotor symptoms and hormonal fluctuations. By reducing night sweats, it helps minimize sleep disruptions. Additionally, hormone therapy can have a direct impact on sleep regulation, with some studies suggesting that progesterone may have a calming effect on the nervous system, promoting deeper and more restorative sleep.
3. Mood Stabilization and Reduction of Anxiety
Hormonal changes during menopause can contribute to mood swings, irritability, and increased anxiety. Estrogen has a known impact on neurotransmitter activity in the brain, including serotonin, which influences mood. Many women report feeling more emotionally balanced after starting MHT, with reduced symptoms of anxiety and depression. This effect can be especially beneficial for those experiencing mood disturbances primarily due to the hormonal shifts of menopause.
4. Relief from Vaginal Dryness and Genitourinary Symptoms
As estrogen levels decline, the vaginal tissues may become thinner, drier, and more prone to discomfort during intercourse, a condition known as genitourinary syndrome of menopause (GSM). MHT, especially in the form of local vaginal estrogen, can help restore the health and function of vaginal tissues, improving lubrication and reducing symptoms like itching, burning, or painful intercourse.
5. Boost in Energy Levels and Cognitive Function
Fatigue and “brain fog” are common complaints during menopause, often linked to disrupted sleep and hormonal changes. By improving sleep quality and mood, MHT can indirectly enhance daily energy levels and cognitive function. Some evidence suggests that estrogen therapy may have direct neuroprotective effects, supporting brain health and helping women feel more mentally sharp.
Long-Term Benefits of Menopausal Hormone Therapy
1. Bone Health and Reduced Risk of Osteoporosis
Estrogen plays a crucial role in maintaining bone density, and its decline during menopause significantly increases the risk of osteoporosis and fractures. MHT has been shown to prevent bone loss and reduce the risk of osteoporosis-related fractures. It is especially beneficial for women who start therapy soon after menopause, as bone density is better preserved when treatment is initiated earlier.
2. Lower Risk of Colorectal Cancer
Some research has found an association between hormone therapy and a decreased risk of colorectal cancer. While the exact mechanisms are not fully understood, estrogen’s potential protective effects on the colon could be linked to improved bowel function and anti-inflammatory properties.
3. Potential Cardiovascular Benefits When Started Early
The relationship between MHT and heart health has been complex and evolving. While some studies have raised concerns about cardiovascular risks, newer research suggests that when hormone therapy is started soon after the onset of menopause (within 10 years), it may offer cardiovascular benefits, such as reducing the risk of heart disease. Estrogen is thought to have a positive effect on blood vessels, promoting elasticity and reducing arterial stiffness, which can be beneficial for heart health.
4. Possible Neuroprotective Effects Against Alzheimer’s Disease
There is emerging evidence that estrogen may have neuroprotective properties, potentially reducing the risk of developing Alzheimer’s disease when MHT is initiated around the time of menopause. Estrogen’s role in supporting brain cell health and function, as well as its anti-inflammatory effects, may contribute to lower rates of cognitive decline in women who use hormone therapy early in the menopausal transition.
5. Long-Term Improvement in Skin and Hair Health
Estrogen is essential for maintaining skin elasticity and moisture, and many women notice changes in their skin’s appearance and texture during menopause. MHT can help support collagen production, reducing the appearance of fine lines and wrinkles. Similarly, it may benefit hair health by minimizing thinning and improving scalp condition, as hormone therapy helps maintain the structural integrity of the skin and hair follicles.
Important Considerations for Menopausal Hormone Therapy
While MHT offers numerous benefits, it is important to weigh these against potential risks, which can vary based on individual health history and the type of hormone therapy used. Risks may include:
- Increased Risk of Certain Cancers: There is an elevated risk of breast cancer, especially with progesterone therapy. However, the risk varies with duration of use and declines after discontinuation, and each patient will be thoroughly screened to see if this increased risk elevates them above average risk. Many of our patients have less than average risk of cancer to start with, so any increase risk with longer-term use of hormone therapy may bring them up to average risk, which is often a number they are comfortable with given the great benefit from symptom reduction they experience.
To maximize benefits and minimize risks, healthcare providers often recommend using the lowest effective dose for the shortest duration necessary. It’s also important to personalize the approach, considering each woman’s unique symptoms, medical history, and treatment goals.
Key Takeaways For Hormone Therapy in Menopause
- Short-term benefits of MHT include relief from hot flashes, improved sleep, mood stabilization, enhanced vaginal health, and a boost in energy.
- Long-term advantages encompass better bone health, potential reductions in colorectal cancer risk, cardiovascular benefits if started early, neuroprotective effects, and improvements in skin and hair quality.
- Personalized therapy is crucial, with ongoing evaluation to ensure that the therapy continues to meet the evolving needs of each woman.
Menopausal hormone therapy remains a valuable option for many women, providing significant relief from bothersome symptoms and offering long-term health benefits. However, decisions regarding MHT should always involve a thorough discussion with a healthcare provider to understand the potential benefits and risks based on individual circumstances.
Your Doctors: Meet Dr. Sarah and Dr. Janna
Dr. Sarah Goulding is a licensed naturopathic doctor in 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. 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.
