Hormone Replacement Therapy: Why It Might Not Work for You
By Ann Melin, Lead Health Coach for Hormone Detox Shop
The question “What do you think of hormone replacement therapy?” is one of the most common I get asked as a health practitioner focused on women’s health.
And, a fair amount of the time, the question is followed up by a client telling me she has been using bioidentical hormone replacement therapy (HRT) but isn’t sure it’s safe and asks if there are natural hormone supplements that might be effective.
Should You Consider Hormone Replacement Therapy?
Although I have had these kinds of questions arise in women of all ages, the decision about whether to use hormone replacement therapy or to seek natural remedies is most hotly considered when women begin experiencing perimenopause and menopause. Common symptoms of this include hot flashes, night sweats, and emotional swings.
As with everything in the world of health, my answer is often somewhere in the neighborhood of “It depends!” Just what you wanted to hear, right?
Seriously, though, there is no one right answer on this subject and each woman has her own symptoms and health history that needs to be factored into any decision. I have certainly witnessed circumstances in which the use of hormone therapy for women is highly beneficial. I have also seen some women respond extremely well to using herbal remedies for menopause and perimenopause.
The Biggest Problem with Hormone Replacement Therapy
Unfortunately, many women are not properly tested when they start using hormones and even more women do not have their hormone levels monitored after they begin using hormones. I believe this is a major problem that can exacerbate hormone imbalances.
It’s confusing, because many symptoms of progesterone deficiency mimic symptoms of estrogen deficiency (and also mimic symptoms of cortisol dysregulation).
For example, it is not unusual for perimenopausal women to experience symptoms consistent with estrogen depletion, when they actually have elevated levels of estrogen and suppressed levels of progesterone. Many of these same women have been recommended BOTH estrogen and progesterone hormone therapy by other providers based upon symptoms alone. Not desirable!
Blindly supplementing with estrogen when it is already dominant can lead to estrogen dominance. This can be a dangerous condition that drives issues such as uterine fibroids, fibrocystic breasts, endometriosis, endometrial polyps, and even cancers, like breast cancer and ovarian cancer. Although it is natural for perimenopausal women to go through some months when estrogen becomes more dominant, we definitely do not want to provoke those conditions through the unmonitored use of hormones.
Should Anybody Ever Use Hormone Replacement Therapy?
Lest it sound like I’m against hormone replacement in every case, let me assure you I am not. In fact, I have been using progesterone therapy for many years now because I have a personal history of endometrial polyps and ovarian cysts. The progesterone helps to balance excess estrogen and to lighten monthly endometrial proliferation.
Blindly using hormone replacement therapy without knowing the actual levels of hormones is dangerous. But through the use of sophisticated lab work, like the DUTCH test, I can get a clear view of hormonal imbalance and gather information about the potential benefits of varied approaches.
If you’re going to use hormone replacement therapy, make sure you know why you’re using it and make sure you get properly tested and monitored along the way!
Should You Pursue Natural Alternatives?
Many women are looking to integrate natural alternatives to HRT (hormone replacement therapy) and, as I stated earlier, I have seen some remarkable results. Of course, you still need to know what you’re taking and why you’re taking it.
For example, I have many women who come to me already using herbs like maca and ashwaganda in efforts to promote balanced female hormones. While both of these herbs are WONDERFUL under certain conditions, I often see lab results from these women showing elevations of DHEA without the intended benefits to the female sex hormones.
Despite what any research or anecdotal evidence might suggest, each woman is unique and it is absolutely impossible to know how you respond to any herb, supplement, or medication without looking at the impact on your individual physiology. And it is for this reason that I will always recommend testing rather than guessing!
Once women have their lab results, they often wonder if herbal therapies will actually work and, again, the answer is, “It depends!”
Some women respond very well to herbal approaches; however, it often takes a little bit longer to experience the benefits. In general, you have to use herbs for hormones for about 90 days before they will really start to drive a noticeable shift in hormones.
In many cases, I feel that herbs are a wonderful option in that they promote regulation of hormone production via the hypothalamus-pituitary-gonad axis thereby regulating and stimulating the function of the endocrine organs rather than simply replacing what the body is not producing efficiently. This strategy helps to encourage appropriate levels of hormone production that fall within optimal ranges.
I have had clients completely eliminate their hot flashes and night sweats through the use of appropriately developed herbal formulas.
I have had clients experience more comfortable intercourse, enhanced libido, and increased vaginal lubrication from the use of herbal remedies.
The primary caveat to this is that you must have all of your organs in order for this to work; meaning that women who have had complete hysterectomies probably won’t experience much benefit from using herbs to help them regulate their symptoms of low estrogen and progesterone.
My Favorite Herbal Formula for Female Hormone Balance
With all of that said, my favorite formula for working with all kinds of female hormone imbalances includes the herbs mentioned below in the indicated ratios. (And I can’t put this out there without another reminder that everybody is different and I will usually customize the formula when I’m working with people individually.)
*Note: I usually am referring to volume when I indicate a “part.”
5 parts Vitex. This is an herb that helps to promote production of progesterone.
3 parts Black Cohosh. This is an herb that helps regulate estrogen production.
3 parts Red Clover. This is a phytoestrogenic herb, meaning that it resembles estrogen and has estrogen-like effects on the body.
2 parts Ashwaganda. Supports DHEA production and can help support the adrenal system.
2 parts Motherwort. This herb helps to enhance the synergy and efficacy of the blend of herbs. (Note: Motherwort is generally contraindicated in those with thyroid conditions… another reason to have proper testing and assessment prior to use)
You can use these herbs in tincture form from companies like Herb Pharm or Gaia Herbs. In this form, a reasonable dosage would be about 30-40 drops of the blend up to four times per day.
You can also use the cut and sifted form of the bulk herbs and blend them into a tea. I personally like this approach as it forces you to experience the taste of the herbs (as bitter as they might be), and taste immediately sends certain signals to the brain about what is being ingested and what the body needs to do to integrate it.
If you want to use a tea, you can order herbs from a place like Mountain Rose Herbs. You will make the mixture of herbs and then take 2 tbsp of that mixture, put it in a glass bowl, and cover it with two cups of boiling water. Cover the herbs and let them steep overnight. Strain the herbs out of the tea in the morning and separate the tea into two halves. Drink one half in the morning and the other in the evening.
Of course, both of the above suggestions are labor-intensive yet many women have a lot of demands and prefer something simple! In this case, Pure Encapsulations has a great product called PhytoBalance which contains several of the herbs mentioned above.
How to Properly Test Your Hormones
Knowing your actual hormone levels is the most crucial piece of attaining proper relief from your symptoms. There are many treatment options available and almost all of them have appropriate uses. However, it is nearly impossible to achieve balance if you don’t know exactly what is out-of-balance and how far out of balance it is. Once you know where you’re starting from, it becomes much easier to identify strategies to optimize health and well-being.
The DUTCH test is my favorite way to get a clear picture of hormonal imbalances in my clients. Check out my video, below, to learn which hormones the DUTCH test measures and why the it’s so effective in guiding hormone treatment plan.
You can also read my in-depth blog on the benefits of the DUTCH test here.
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Ann Melin is a certified Holistic Health Practitioner, Clinical Nutritionist, a Clinical Master Herbalist, and a Functional Diagnostic Nutrition® Practitioner, and has been in the field of health since 2001. We are extremely blessed to have her as our Clinical Director and Lead Health Coach for Women’s Wellness Collaborative as she has extensive experience in running labs and creating holistic protocols based on the principles of functional nutrition. She lives in Vermont.