The Reality Of Menopausal Hormone Therapy (MHT)

There has been a great deal of misunderstanding and controversy about menopausal hormone therapy (MHT). Inaccurate reporting of results from the Women’s Health Initiative (WHI) study nearly two decades ago in 2002 led to fear and concern that MHT causes increased risk of breast cancer and cardiovascular disease. These inaccuracies were clarified by many updated and new studies demonstrating the safety of MHT for healthy women younger than 60 years and who are within 10 years of menopause. The overall benefits of MHT generally outweigh the risks in women with bothersome symptoms.

Many women are curious about MHT. However, many primary care practitioners are unfamiliar with updated hormone therapy guidelines and don’t feel comfortable discussing MHT options with their patients.

MHT, previously called hormone replacement therapy (HRT), is an umbrella term used to group the two types of hormone treatment available to women to alleviate hot flashes, night sweats, and genitourinary symptoms of menopause like vaginal dryness. Women at an elevated risk of bone loss/fractures may also be prescribed MHT to reduce bone loss due to a decline in estrogen.

Compounded bioidentical hormone therapy (cBHT) has been touted as a safer and more effective MHT alternative. Bioidentical hormone therapy that is FDA-approved is a safer alternative and endorsed by all medical societies. There is no scientific evidence to back the claims of clinicians that prescribe non-FDA-approved cBHT. When a medication has FDA approval, it must adhere to certain quality standards. Non-FDA-approved cBHT formulations can vary greatly in purity and composition. A study and an investigative report by More magazine have proven this to be the case.

Whether cBHT is FDA approved or not, you should be aware of what bioidentical means. Many women assume that cBHT is the same as the estrogen their body naturally produces. The term "bioidentical" means the hormones in the product are chemically similar to those your body produces. The term "natural" means the hormones in the product come from plant or animal sources. They are not found in this form in nature but are made or synthesized from plants like yams and soybeans. However, many of these products still need to be commercially processed to become bioidentical. They are greatly altered in the lab and are no longer natural when the processing is complete.

To learn more about MHT and whether it’s right for you, check out our expert guide by leading menopause researcher and clinician, Dr. Risa Kagan. Dr. Kagan explains when to start and stop, the benefits and risks, potential side effects, natural alternatives, and evidence-based holistic strategies for symptom management. 

In this guide, we’ve tried to lay out fact-based information about MHT to dispel the myths and inaccurate information circulating for several years. The decision to use MHT is an individual one and one that you should feel good about. Ultimately, like with any medical decision, it’s your body and your choice. 

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