Why is HRT (hormone replacement therapy) so confusing?

I could go on and on about the different claims that have been made from before the WHI (Women’s Health Initiative) and since…but first, I believe it’s critical for all women to understand the following, if you don’t already.

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1. Definitions: know the difference between menopause and perimenopause. Menopause is one day = the 12 month anniversary of your last period. Perimenopause is the phase of life leading up to that day. It can last from 5-15 years and this is a hormonal fluctuation phase of life where you still have a period (although it may be changing/irregular/heavier or lighter than you are used to.) Why is this important? Because many experiences happen in perimenopause while many women and doctors believe that if you still have a period, it’s not menopause-related. It’s confusing when everyone is not on the same page from a language and definition point of view.

Also know the definition of hormone therapy. Note that I removed the word “replacement.” For example, one woman told me: “My doctor doesn’t believe in hormone replacement therapy. He says it increases the risk of cancer, heart attack and stroke. So, he put me on the pill instead!” If you don’t see the red alarm bells in this anecdote, send me a message and we will talk! Hint: the birth control pill IS hormone therapy.

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2. Blanket statements. As a society, we tend to look for blanket statements such as “this works (for all women)” or “this causes breast cancer”. The truth is we are ALL UNIQUE creatures with unique biological make ups and personal health and family histories. What is right for you, will not necessarily be right for me.

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3. We must learn to be our own best health care advocate. That requires a paradigm shift from thinking your doctor or health care pro has the answers. YOU must be the leader of your midlife health care team. And when it comes to deciding if hormone therapy (or any other form of intervention or aid for that matter) is right for you, it’s a personal choice and an individualized choice to be made after weighing the risks vs the benefits.

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I was interviewed on CBC The National last night (starts at 25 minute mark) about the latest news on HRT coming from the Society of Obstetricians and Gynaecologists. Their message is this: no significant increase in breast cancer with short term use of HRT.

The news piece also says the best way to find out more is to consult a gynaecologist. Of course, that is not true. If you live in Canada, you know you need a referral to see a gynaecologist. Your GP, family doctor, naturopath, or professional hormone balance expert can support you in your decision.