Hormone Replacement Therapy

Hormone replacement therapy (HRT) helps women replenish hormones that begin to drop naturally as she enters menopause. HRT is the most effective treatment proven to relieve unwanted menopausal symptoms like hot flashes, mood swings, low sex drive and more. These hormone deficiencies and imbalances are a normal part of life but treating with hormone replacement therapy can drastically improve and relieve these symptoms. Reference

Our providers review your labs with an expert eye considering all of the many factors involved in balancing and personalizing your treatment plan.

  • Estrogen (estradiol) and progesterone levels
  • Testosterone levels (free and total)
  • Symptoms
  • Lifestyle
  • Health history
  • DHEA-S hormone
  • Cortisol levels
  • Thyroid function

How long should women take hormone replacement after menopause?

The North American Menopause Society, both estrogen therapy and estrogen with progestogen therapy increase the risk of blood clots in the legs and lungs, similar to birth control pills, patches, and rings. Although the risks of blood clots and strokes increase with either type of hormone therapy, the risk is rare in the 50 to 59 age group.

An increased risk in breast cancer is seen with 5 or more years of continuous estrogen/progestogen therapy, possibly earlier. The risk decreases after hormone therapy is stopped. Use of estrogen alone for an average of 7 years in the Women’s Health Initiative trial did not increase the risk of breast cancer. Reference

Is hormone replacement therapy Safe?

In a 2017 study, 27 347 women with an average age of 63 years were observed on hormone replacement therapy for 5 to 7 years. The researchers found no different that the death rate between treated and untreated women on hormone replacement therapy. Reference

According to the North American Menopause Society, “Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms. Individualization is key in the decision to use hormone therapy. Consideration should be given to the woman ́s quality of life priorities as well as her personal risk factors such as age, time since menopause, and her risk of blood clots, heart disease, stroke, and breast cancer.”

What are the benefits of HRT?

Let’s start off with an important correction on HRT research and review THE study that most Doctors and health organizations to claim that Hormone Replacement Therapy may only prove risky for women. The 2002 study’s sole purpose was to see if HRT was a good preventive measure for major health issues and disease. The study did not look at cause of death or specific death rates related to the health issues and HRT, which is an important thing to consider. Let’s take a look.

In 2002, 16,608 postmenopausal women aged 50-79 years were observed on HRT as a preventative treatment for major health issues (heart disease, stroke, cancer, broken bones etc). They found that while menopausal symptoms improved, risk of health issues did not improve. They found that hormone replacement therapy should NOT be used to prevent major health issues. It’s important to note that the researchers show a good “Risk Reduction” of 6 fewer colorectal cancers and 5 fewer hip fractures in the total population of women on HRT. With the complex benefits and risks of balancing hormone therapy, looking at the death rate outcome (all-cause mortality) provides us with important insight on the effects of HRT vs. life-threatening health issues. Reference

In 2017, Harvard Medical did an 18-year follow-up review on 27,347 postmenopausal women including the 16,608 women from 2002 study. Researchers found no significant difference in risk of death between the treated (27.1%) and untreated (27.6%) groups.

A deeper look at the findings show us that there is no association with risk of cardiovascular, cancer, or death in general while on treatment.

The data revealed that women who started HRT in the first 10 years of menopause slowed risk of premature death and heart attack or stroke. Perhaps these women were also indirectly impacted by way of improvements in quality of life, energy, and sex drive.

Basically… “I think we can provide reassuring evidence that hormonal therapy is not going to kill you,” said Doctor JoAnn Manson of Brigham and Women’s Hospital and Harvard Medical School in Boston, who led the study. Reference

This should be reassuring for menopausal women who may be fearful of HRT. According to the Agency for Healthcare Research and Quality, 17.9 million women used HRT in 2001, by 2009 only 8 million based on reactions from the published study.

While the numbers have stabilized in recent years, more thorough diagnostics are going into keeping women safe and there should be a “dial-in” period. Like TRT and PSA levels in men, annual mammograms should be required to screen for any cancer markers during HRT. (mammograms are important regardless. You should get one every year, perhaps every 2 year between the ages of 50 and 75).

Like we do with our TRT protocol, diligent monitoring levels are critically important when balancing a complex set of hormones like estrogen, progesterone and testosterone.

“This is a complicated health issue, where the same treatment offers benefits in some women, but harms in others,” Dr. Henry Boardman of the Department of Cardiovascular Medicine at the University of Oxford, who led the review team, said in a statement. Reference

A majority of researchers and organizations agree that younger women transitioning into menopause (age 51, +/-10 years) should consider hormone replacement and balancing therapy as a good option to feel their best and relieve the rough symptoms of menopause. Older women may still consider HRT finding comfort and the fountain of youth but caution close watch and diligent follow ups.

Personalized lower-dose HRT formulations have proven effective and safe. We use methods, such as patches or topicals to help you manage your levels throughout your treatment plan. Reference

  • To summarize these three studies, most all doctors agree that hormone replacement should not be prescribed to prevent heart disease.
  • There is extensive evidence that HRT is safe and extremely effective in younger pre or postmenopausal women.
  • Risks of breast cancer and other issues mentioned above increases in women over the age of 59.
  • Dialing in and balancing levels through blood work is a critical step to start and maintain health hormone levels.
  • Patches, injections or Topical vs. oral medication may be safer and easier to adjust without involving the liver, where the blood clots start. This is called first-pass metabolism.
  • Exercise helps, as do other non-hormonal strategies. But some women may need hormones replacement to normalize hormones while using non-hormonal supplement therapy.

If women are dealing with hot flashes, sleeplessness or other life-altering symptoms of menopause, HRT may be a manageable risk willing to take to relieve your discomfort to starting living life to its fullest. Proper management is important.

What is Menopausal Transition (Perimenopause)?

The menopausal transition is the period of time between women’s reproductive years and menopause. The average age for menopause is 51 years, so consider this a 10-year period before turning 51 years. Perimenopause leads to menstrual irregularities, vasomotor symptoms, sleep issues, moodiness, and urogenital tract atrophy – Ex: Vagina Dryness, Overactive peeing, irritation, something-doesn’t-seem-right. These symptoms affect self-esteem, quality of life and self-comfort. Reference

In 2020, researchers reviewed blood tests from 1,537 women between the ages of 42 and 63. With newer more sensitive tests, the group monitored changes in the women’s health, specifically the anti-Müllerian hormone (AMH), making it possible to predict the final menstrual period’s timing within 12 to 24 months (vs. the traditional 4-year window) in women in their late 40s and early 50s. measuring levels of can predict when a woman’s final menstrual period will occur. Reference, Reference

What are the 34 symptoms of menopause?

Hot flashes

The most common indicator for HRT are hot flashes. Hot flashes affect roughly 85% of menopausal women. 55% experience hot flushes as they enter perimenopause.

Hot flashes are associated with menopause and improve following hormone replacement therapy, estrogen deficiency shows to play clear role as a trigger.

Estrogens boosts the production of serotonin and endorphins. According to researchers there is 50% decrease in levels of serotonin after menopause confirmed by the decreased level of estrogen. Simply put, when serotonin levels decrease our bodies natural respond by sending an adrenaline like enzyme from the brain thinking your body needs warm up when temperatures may be totally normal.

Flushes can last between 5 and 10 years.

Women with a family history of hot flashes may suffer from hot flashes.

Studies show that hot flashes are more serious in:

  • Sufferers of Obesity.
  • Women of African descent
  • Sufferers of premenstrual syndrome
  • Those with a sedentary lifestyle.

Hot flushes can lead to heart disease, Osteoporosis, and sleep issues.

In 2019, the North American Menopause Society from the Study of Women’s Health Across the Nation discovered that women who experience frequent (flashes ~6 out of 14 days) hot flashes are more at-risk of experiencing a heart attack, stroke or serve cardiovascular issues.

Do not panic. The researcher says, “This also doesn’t mean that all women with hot flashes have, or are going to get, cardiovascular disease.” This is cautionary insight into the complex nature of hot flashes. Reference

Women who still have a uterus need to take a progestogen or progesterone along with the estrogen to prevent cancer of the uterus. It’s recommended that five years or less is a reasonable and safe duration to use a combined treatment, but a personalized treatment plan can be tailored to your protocol. Reference

Night sweats

Night sweats are hot flushes that disrupt sleep or can lead you to feeling unpleasant when you wake up.

Irregular periods

As women enter the end of the reproductive years, periods will start to dissipate as your hormone production decreases. These can be very erratic; sometimes leads to PMS episodes.

Mood swings

With studies showing that mood swings affect 27% of menopausal women, this can feel like a more extreme version of the mood swings you may have experienced during your periods. Reference

Elevated inflammation in women entering menopause may worsen menopausal symptoms according to a study published in the Journal of Women’s Health.

Out of the 2939 women with higher inflammation;

  • 41% Experienced weight gain and bloating
  • 27% Moodiness
  • 40% Serve cramps and backaches
  • 26% Breast pain

Compared with women with lower CRP levels. Reference

Vaginal dryness

Your natural lubrication is maintained by your estrogen levels, so as these begin to drop, you may notice vaginal dryness. This can cause some pain and discomfort, particularly during sex. Thankfully, there are a number of remedies for this, including lubricants and moisturizing creams.

If women have only vaginal dryness or discomfort with intercourse, the preferred treatments are low doses of vaginal estrogen.

Decreased libido

While a man’s sex drive is largely controlled by testosterone, a woman’s is primarily controlled by estrogen. As we’ve already established, these levels drastically drop during menopause, which can reduce your sexual appetite.


These are typically more common for women who experienced them during their periods. You can get some quick relief from 4head cutaneous stick or Kool ‘n’ soothe but if headaches persist then you may be suffering from migraines and should visit your doctor.

Breast soreness

Any time in your life when your hormones drastically change can create the same symptoms; this is typically menstruation, pregnancy and menopause. So while breasts can become sore while on your period or pregnant, it can also happen during menopause.

Burning mouth

It’s not quite as common as some of the other symptoms, but decreased levels of saliva during menopause can lead to what’s known as ‘burning mouth syndrome’. This is a hot sensation that affects the tongue, lips, cheeks and roof of the mouth.

Joint pain

Not all joint pain may signal arthritis, but the menopause is a common time for women to develop musculoskeletal symptoms.

Digestive problems

Your digestive system is one of the most sensitive systems in your body and is often the first thing to get disrupted due to any major changes to your body (new medications, new foods, nervousness). Changes to hormones are another major body change that can lead to stomach upsets such as bloating, indigestion, constipation, diarrhea and cramps.

Electric shocks

Because of the erratic changes going on in your body during menopause, you may notice that you experience more electric shocks. It’s also common to get these just before a hot flush.

Muscle tension

This can often be closely linked to stress and anxiety and presents itself as a feeling of tightness in the muscles, like a strain.

Gum problems

Affecting between 10 and 40 percent of menopausal women, gum problems are often accompanied by a metallic taste in the mouth.

Tingling extremities

It’s not overly common but a tingling sensation can appear on any part of the body. This is usually in the feet, hands, arms and legs.

Itchy skin

Low estrogen levels can also lead to low collagen levels. Collagen is responsible for keeping skin plump, firm and healthy so with less of it, you may notice that skin can become thing, dry and itchy. Be sure to combat this with an intensive moisturizer.


One of the more common symptoms of menopause, many women will notice a feeling of extreme tiredness.


Along with mood swings, menopausal women may notice increased feelings of anxiety. As many as one in three women may experience this during menopause. To help calm feelings of anxiety, you could try a herbal supplement, such as Passion flower.

Disrupted sleep

Because of all the changes going on in your body (as well as the other menopausal symptoms), you may also experience disrupted sleep and insomnia. If this persists, sleeping tablets may be able to help.

Hair loss

While most people are aware that a lot of men lose their hair as they get older, not everyone realizes that women get this too. Menopause can act as an accelerator for hair loss, leaving it looking thinner.

Memory lapses

These are usually only temporary but memory lapses can occur during menopause. Try some brain training exercises to strengthen cognitive function.

Difficulty concentrating

The brain doesn’t work as hard during menopause because estrogen is the hormone that pushes it to burn glucose for energy. With lower levels of estrogen, you end up with a lack of focus and concentration.

Weight gain

Mid-section – 90% of women will gain at least 5LB in the first year. Even if you don’t there is redistribution. Must get rid of hot flushes.

Many women notice weight gain when they start taking the contraceptive pill, caused by a major change in hormones. The major change in hormones during menopause can also cause weight gain but this can usually be combated by healthy eating and exercising. If you are unable to lose weight on your own then you may find that weight loss pills are able to help.

In 2019, a group from UCLA and National Institute on Aging looked at 1246 ethnically diverse women with an average age of 52 years found a strong connection that menopause transition affects women’s metabolism. Roughly 2 years after a woman’s final menstrual period, rate of weight gain doubled and lean muscle drastically decreased. Reference


Vertigo and feeling dizzy during menopause are thought to be caused by the drop in oestrogen production.


This usually occurs right at the start of your menopause and could even be one of the first symptoms you notice. If you’re still having periods but are constantly feeling bloated then this could be a hint that your menopause is coming.

Stress incontinence

A lot of women will already have experience incontinence as a result of childbirth, but this can increase around menopause. However, this could be more related to age than the actual menopausal process.

Brittle nails

Lower estrogen levels and dehydration can leave your nails feeling brittle and can make them snap or break more easily.


While you may never have had a problem with certain things before, you may notice allergies or intolerances during or after menopause. This is because hormones are very closely linked to your immune system.

Irregular heartbeat

Lower estrogen levels can overstimulate the nervous system and circulatory system, which can, in turn, lead to heart palpitations or an irregular heartbeat.

Body odor

Not only can the menopause make you sweat more, but the change in hormones can also actually change your natural scent. If you find that excessive sweating is disrupting your life then you can find effective remedies at UK Meds.


Your hormones play a large role in contributing to your emotions and the fluctuation can lead to feelings of sadness or irritability.


In more extreme cases, this change in emotions can lead to depression. Depression is four times more likely to affect women of a menopausal age than a woman below the age of 45.

Panic disorder

Menopausal women are actually more susceptible to panic attacks than almost anyone else. If you are looking for a natural remedy to help you keep calm, try RelaxHerb.


Bone density can drop by up to 20% after the menopause, which puts you at risk of osteoporosis. Be sure to look after your bones with a healthy balanced diet and calcium vitamins.

Although it may sound like no walk in the park, not every woman will experience all 34 symptoms of menopause. Hormone replacement therapy is an effective treatment to keep symptoms at bay and make the 5 years that menopause lasts, more bearable. Explore effective options at UK Meds now. Reference

How much Hormone Replacement do I need?

Our providers will personalize your dose to the lowest threshold that helps you feel great and deters side effects.

Can HRT reverse aging?

For women under the age of 60 and within 10 years of menopause, research shows estrogen replacement may have a beneficial effect on cardiovascular health and bone health, and may reduce risk for diabetes. Reference

Is HRT FDA approved?

Yes, HRT is FDA approved.