By Menopause Moxie July 19, 2013 - 5:50pm

In the ten years I worked at Quality of Life Medicine in Northern California, I educated every patient about how Hormone Replacement Therapy (HRT) works, what types of HRT was available, what the risks where for each type, what they could expect from the type of HRT they chose, and what their role was in successful hormone balancing. HRT is not for everybody but it can be life changing for a lot of miserable women if done correctly. Women don’t know they have a choice in HRT; some hormones are good, and others not so good. In fact, most doctors don’t know there are HRT options, and one of the biggest problems women face is finding a doctor with formal training in cyclic hormone restoration and a successful patient base. They don’t teach hormone restoration in medical school. Doctors learn what menopause is, and are instructed to manage the symptoms of it with low, static dose, synthetic hormones and/or toxic prescription drugs. Hormones don’t work like that so why is that the HRT standard of care?

Before a patient started any type of HRT in our practice, my job was to let them know what they can expect from each type of HRT so they could make an informed decision. This meeting took place over a two-hour period, and I also got to know the patient’s perspective on HRT. Patients were also generously forthcoming about what their primary care provider thought about HRT. I shook my head in disbelief that doctors are being so bold as to offer their strong opinion about HRT when they have no education, clinical training, or patients they’re successfully treating. It’s confusing for patients because they assume their doctor is educated in such things so when a doctor makes a blanket statement, the patient believes them.

Below is a list of the most common misconceptions about HRT based off roughly 4000 female patients:

1. Hormones Cause Cancer

If this were true, we’d all be dead. Synthetic hormones cause cancer, bioidentical hormones do not. You are at greater risk for cancer if your estrogen is in the tank. Estrogen is especially designed to protect a woman’s body from the degenerative diseases of aging, including cancer.

2. There is Only One Kind of HRT

There a couple ways to treat hormone deficiencies; treat the symptoms with a synthetic or natural low, static dose, or restore natural hormones to optimal levels, dosed in a cyclical manner that mimics a woman’s natural cycle.

3. Hormones Are for Old Women

There is a huge misconception that we get our hormones at puberty, and we all produce enough. PMS, perimenopause, and menopause are a direct result of estrogen deficiency, and can happen at any age.

4. Too Old for Hormones

Many women think once they’ve “passed” the “change”, they don’t need hormones. When women say this, it tells me how much they don’t know about HRT and the benefits of replacing the hormones that give life. Women feel much better on the right kind of HRT. With the right amount of estrogen, a woman can rebuild her bones, decreasing her risk, or reversing osteoporosis.

5. Doctors Know How to Prescribe HRT

Make sure before taking hormones to ask your provider where they received their hormone training. Your doctor may have a strong opinion about hormones but are not forthcoming with their lack of knowledge in this area, and can make a mess of the patient. It’s okay to ask your doctor about their training and the focus of their practice. It’s your body and your life. Hormones regulate everything in the human body, and you have a right to proper HRT.

6. Lowest Dose is Best

With the lack of knowledge and training in HRT, doctors are telling their patients the lowest dose is best for hormones. This is so far from the truth. This method is taught in medical school with the mindset of estrogen causes cancer so give the lowest dose for the shortest amount of time. Hormones need to be restored to levels that mimic a healthy woman, not an unhealthy woman. The goal is to fix the cause of hormone deficiency by naturally restoring hormones instead of treating the symptoms of hormone deficiency with a low dose.

7. Use Only for the Shortest Amount of Time

Uneducated doctors suggest this because they’ve been lied to that hormones cause cancer. If a woman’s hormones are balanced correctly, she will want to be on them as long as she can. Staying on them as long as she can will help her fight and reverse the degenerative diseases of aging, and make her feel good.

8. Use the Same Dose Everyday

This is a one-size-fits all mentality. I still haven’t come across a woman who has by exact physical issues or body. Every woman’s body works a little differently but one thing remains consistent if a woman is hormonally healthy and that is women’s bodies cycle with the phases of the moon (men’s bodies cycle with the solar system) and so does her hormones. On day six of a woman’s cycle, her estrogen begins an incline and peaks on day 12 (full moon), then falls to a low by day 18. Estrogen makes another incline peak at day 21 and drops again so a woman can shed her lining. Why give the same dose everyday if our bodies don’t function that way. One cannot have proper HRT if the hormones are not cycled and optimized.

9. HRT is a One-Size-Fits-All Regimen

No two women are the same. Uneducated doctors read the hormone sample insert in the box on how to dose the hormone, slap a patch on the patient, and call it HRT. Proper hormone restoration involves dosing the patient based on her body size, body type, level of deficiency, and how long they’ve been deficient. These are very critical elements in dosing. I tell my patients the regimen that works for me, wouldn’t work for them, and their HRT would do me any good. My body is very sensitive to testosterone so I take about a tenth less than a woman with average tolerance.

10. HRT is Quick and Simple

The last thing proper HRT is: quick and simple. Patients who are looking for a quick fix get terribly disappointed. Proper HRT is not conventional medicine. Every patient is different and needs to be dosed and treated as such. Proper HRT is a process over a period of time. The first month a patient is on the correct hormone protocol, they feel better but they’re skeptical about why they feel better. The second month is better than the first month because estrogen receptors are waking up, and can receive and utilize the estrogen. Each month more estrogen receptor sites are awakened, making the patient feel better and better, for some women up to a year.

If you have any questions, or would like me to expand further on a particular topic, feel free to mail me directly at [email protected], or leave a comment.
M.