Understanding Your Menstrual Cycle Part 6: What Is HRT and MHT And Is It Right For Me?
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The last 6 or so weeks we’ve talked about phases of the menstrual cycle and what we’re looking for, and what an IUD or oral contraceptive do.
So now, where does HRT/MHT (hormone replacement therapy or menopausal hormone therapy) fit in?
This is a question I get a lot in clinic, so let's get into it!
Where does the pill or IUD fit in for period health?
Why Use It?
Hormone replacement therapy (HRT) or hormone therapy (HT) or menopausal hormone therapy (MHT) are all the same thing and are a treatment used to decrease symptoms associated with perimenopause and menopause resulting from the lack of production of hormones as ovary function declines.
What's Involved?
HRT typically involves the use of a topical estrogen (patch or gel) PLUS oral progesterone; but can take a variety of forms depending on someone’s needs and whether they have had a hysterectomy or IUD.
HRT does not block ovulation, so it does not prevent pregnancy, and someone in perimenopause using this therapy could still have fairly regular menstrual cycles.
What Does It Help?
HRT can be a very effective strategy for hot flashes and night sweats resulting from low estrogen, but can also positively impact brain fog, joint pain, mood challenges, insomnia, vaginal tissue health, and bone density for some people.
How Does It Work?
It is providing a low level steady state of estrogen and progesterone, essentially ensuring that someone in perimenopause/menopause doesn’t dip too low. In perimenopause, one’s natural production of estrogen and/or progesterone at certain times might be much higher than this, the intention here is that the lows aren’t quite as low.
Because it doesn’t block ovulation or menstruation inherently, it doesn’t tend to be very helpful for true PMS/PMDD or for menstrual pain.
How Does Dosage Work?
The choice of HRT therapy and dosage is determined based on individual needs, symptoms and health considerations, NOT based on bloodwork. While HRT can be beneficial for many women, it also carries potential risks and is not suitable for everyone.
It can be a life-changing intervention for some, but the menopause transition is complex and requires a comprehensive approach to healthcare.
I hoped this helped answer some questions you have about your cycle!
As a prescribing ND in Ontario, I’m able to prescribe HRT for some patients, as I can prescribe topical and vaginal estrogen and progesterone but NOT oral progesterone.
Even if I can’t prescribe what’s required for you, I’m happy to have conversations about the pros and cons and use of HRT in your health journey.
Thank you for following this series with me, if you missed previous parts of this series, be sure to check them out to get the full picture of your amazing cycle.
Disclaimer:
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern. Never disregard professional medical advice or delay seeking it because of something you have read here.
Hi, I’m Dr. Janine, ND
I’m a Naturopathic Doctor currently practicing in Guelph, Ontario, Canada.
I truly believe that our enjoyment of life is closely tied to how we feel physically. When we’re healthy, we can take on anything. But when we feel off, even the simplest tasks become overwhelming. I’ve been through hormonal shifts, sleepless nights as a parent, and the stress of balancing everything. But I also know that with the right strategy, we can go from surviving to thriving—and create a healthy, thriving family in the process.
I look forward to meeting you soon.
- Dr. Janine, ND
Follow me on social media, @dr.janine.nd