Menopause Hormone Therapy, or Hormone Replacement Therapy (HRT) as it is more commonly known is a controversial treatment for symptoms of perimenopause and menopause. Many women are confused about their options when it comes to HRT, and it can be difficult to know how to make an informed choice. 

What is HRT? 

The first hormone replacement therapy drug for menopause launched back in 1941 when Premarin came on the market. Derived from pregnant mares urine, Premarin contained a complex mix of 30 different oestrogen compounds, some with a similar structure to human oestrogen. 
Modern forms of HRT are ‘bioidentical’ or ‘body identical’ which means they are identical to human oestrogen. They don’t carry the same health risks as older forms of HRT like Premarin, and the different options mean women can switch between forms of HRT according to their symptoms. 
Bioidentical HRT preparations are available as pills, skin patches, creams, gels, and vaginal tablets. The Merina coil which is often prescribed during perimenopause uses synthetic forms of progesterone called progestins. 
Some women feel better on a combination of body identical oestrogen and progesterone, while others only need progesterone – especially during early perimenopause. 

Why is HRT controversial? 

There are different viewpoints about HRT. Some GPs are reluctant to prescribe it, claiming that menopause is a normal process with no need for medication. Other healthcare professionals see women as being hormone deficient after menopause, in need of HRT for the rest of their lives. One thing is for certain: HRT isn’t suitable for every woman. And menopause is by no means a hormone deficiency. 
Side effects of HRT 

Common side effects of HRT include:  Nausea Breast pain, tenderness and/or swelling Mood swings and depression Acne Abdominal pain Back pain Leg cramps Headache Indigestion and bloating Vaginal bleeding 

Common side effects of HRT include: -	Nausea -	Breast pain, tenderness and/or swelling -	Mood swings and depression -	Acne -	Abdominal pain -	Back pain -	Leg cramps -	Headache -	Indigestion and bloating -	Vaginal bleeding

Hormone excess - not deficiency! 

Remember that menopause is a natural process of hormonal transition and adding in more hormones isn’t always the right approach. This is especially true if you already experience conditions linked to oestrogen excess such as fibroids, PMS, and endometriosis. 
Helping your body process hormones whilst supporting energy levels and mood balance tackles the underlying causes of many menopausal symptoms – without needing to add more hormones to the mix. 

Nutrition and HRT 

No matter what stage of menopause you are at, or whether you are taking HRT, choosing the right foods can help your body adapt to its new hormonal landscape and optimise wellbeing through menopause and beyond. 
Try these 3 tips for hormone support during perimenopause and menopause: 
Include dark green leafy vegetables every day. 
Dark green leafy vegetables from the Brassica family contain compounds that help the liver process and detoxify hormones. Kale, broccoli, rocket, cabbage, spring greens and other Brassicas are rich in indole-3 carbinol, sulforaphane, and diindolylmethane (DIM) that support detoxification enzymes in the liver. 
Top tip: chop your Brassica vegetables and let them sit for 10-15 minutes before lightly steaming or eating them raw. Chopping activates an enzyme that helps the active compounds develop. 
Balance blood sugar levels. 
To help manage anxiety, brain fog, hot flushes, and low energy, swap refined carbohydrates like white bread, pasta, cakes, fruit juice, and sweets for complex carbs instead. Opt for wholemeal pasta, wholegrains, whole fruits, and root vegetables. Include a palm-sized portion of protein with each meal to help slow the release of sugars into your bloodstream. 
Cut out caffeine. 
Caffeine is a major trigger for hot flushes and anxiety. Reduce your intake gradually to avoid withdrawal headaches and replace regular tea and coffee with fruit or herb teas and plain water. 
Every woman has their own unique experience of menopause and deserves tailored support to help them through it. If you’re wondering what nutrition and lifestyle medicine can do for you during this time of hormonal transition, book your FREE discovery call with me today. 
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