Before we get into hormone replacement therapy, we need to address the elephant in the room.

Menopause is a normal life stage we should embrace wholeheartedly, not a disease we need to treat or a condition we should be ashamed of or dread.

This is a stage of life to be embraced for the possibilities. We’ve been the caregiver for our families and now we get to focus our attention on us. It’s a time to manifest our dreams. We no longer have our menstrual cycle anchoring us to certain roles, responsibilities, places or time.

Menopause should feel like freedom and reckless abandon to love and enjoy every moment in life with the people in our life.

But, for the 6,000 women entering menopause every year in the US, 85% feel like crap.

They don’t know what to wear because they are hot when they should be cold and vice versa. They can’t find their keys, they can’t sleep, they feel more anxious and moody, their body hurts…

They may even feel like they are going crazy.

They are not experiencing the freedom they should be in this stage.

I don’t believe God designed women in such a way that they would need to suffer when they no longer cycle or even when they are going through the change from cycling to not cycling.

So, why are women feeling awful during the time of life when they should feel more alive?

Here are three key reasons:

1. Stress – we have so much chronic stress in today’s world from things like traffic, jobs we hate, poor diet, financial woes and more, and stress creates an imbalance between estrogen and progesterone.

2. Birth control – tricks our body into thinking it’s pregnant and suppresses our natural hormone production.

3. Toxins – deplete our body of nutrients that support healthy hormones and also contribute to stress.

So, while we shouldn’t require any kind of hormone replacement, the conditions we live under are making it difficult to create the hormones we need naturally. That is where Hormone Replacement Therapy or HRT comes in.

As if stress isn’t bad enough, there is a lot of conflicting information about HRT.

Some doctors think estrogen is like magic and solves all your menopause issues and helps you live longer. Others think estrogen causes breast cancer. So, who do you believe?

The doctors are conflicted because the science is conflicting and not clear at all. This is one of the problems with women’s healthcare; we lack studies and the studies we have are sub-par. Women’s healthcare is still in the dark ages, unfortunately.

And then we have all the fear surrounding breast cancer and osteoporosis to contend with. Fear does not lead to good decisions, so let’s, at least for a moment, let go of any fear surrounding this topic and stick to some facts that I think are available and reasonably clear.

First, HRT should be a decision you make with your doctor and ultimately it is your decision. Make that choice from a place of peace.

What I have found in the science are three things you do not want to do if you and your doctor decide HRT is right for you:

1. Do not use synthetic hormones, especially synthetic progestins as these do seem harmful. Most progestins are made from testosterone, not progesterone. If you do HRT, insist on bioidentical hormones.

2. Do not use estrogen without progesterone. Progesterone may be the only hormone we really need to think about replacing, but what the science does show reasonably well is that there is no downside to progesterone. There may be a downside to using only estrogen, but there appears to be no downside with estrogen if it is combined with natural progesterone. So, you are safest with progesterone only or estrogen with progesterone, but not with estrogen only.

3. Do not just do HRT. Hormones are great, but they are not the root cause. You want to improve energy production in the body which means you need to consider your diet, the nutrients you are getting, your lifestyle habits, your stress levels, your toxic exposures… giving hormones in isolation might help a little, but they can only take you so far.

If you want to feel great, you have to put in the work of changing your diet and lifestyle. That doesn’t mean you have to give up everything you love or do things you hate. It just means you have to pay more attention and make your health and well-being a priority.

I do think the science gives us a few reasons to be cautious with estrogen.

When we are stressed, we secrete the hormone cortisol which increases estrogen, and they are on a feedback loop; the more cortisol, the more estrogen and the more estrogen, the more cortisol.

Estrogen is a stress hormone, not THE female hormone. This is one reason stress has such a big impact on how we feel through perimenopause and menopause.

Estrogen also blocks the DAO enzyme which leads to more histamine production which leads to allergies and food intolerances, and the histamine also increases estrogen. Another feedback loop.

Estrogen raises thyroid stimulating hormone which leads to an under-functioning thyroid.

Estrogen increases serotonin which, contrary to popular belief, is not the happy hormone. Too much serotonin contributes to depression and anxiety.

And, estrogen increases lipolysis, a process in the body where we break down our body fat, which may sound like a good thing, but these fats are inflammatory and can lead to insulin resistance.

So, with higher levels of estrogen, you are looking at insulin resistance, depression and anxiety, allergies and food intolerances, and higher levels of cortisol which will increase cravings and help you put on more weight (which is not something most of us want!).

Could it be that menopause is a state of estrogen excess rather than estrogen deficiency? We need more studies to flesh this out, but it’s something to think about. It should at least cause us to pay attention to how we feel on HRT and adjust as needed.

Menopause is a natural and beautiful state. Suffering through it is optional.

In Japan, women celebrate menopause with a tradition called kanreki. It celebrates a 60-year cycle and is all about renewal and rebirth, and women often receive gifts. Maybe we need more kanreki parties to usher in this wonderful time of life.

If you want a good place for information, check out https://www.cemcor.ubc.ca/.

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