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Hormone Replacement Therapy for Women: Is It Safe?


Jenny Glasshagel

One of the questions we get most often at Restoration Health & Wellness is whether hormone replacement therapy (HRT) is safe. Specifically, women want to know if it will increase their cancer or heart attack risk. There are a lot of myths and misconceptions about HRT and women often get conflicting information even from their trusted medical professionals. While any treatment, including HRT, comes with risks, let’s separate the facts from the fiction. Explore the pros and cons, including significant health benefits and potential risks, to decide if this treatment is right for you.

What is Hormone Replacement Therapy (HRT)?

Hormone replacement therapy (HRT) is a treatment that gives a woman replacement estrogen, progesterone, testosterone, or a combination of all three, to balance out the hormonal effects of hormone decline that happen in peri-menopause and menopause. Many providers, including those at Restoration Health, prescribe only bioidentical hormone replacement therapy. It’s important to know the differences in HRT when deciding what is best for you as synthetic hormones have been shown to have significant health risks, whereas bioidentical hormones have significantly less risk.

Bioidentical hormones are made up of artificial components that are molecularly IDENTICAL to what the human body naturally produces, essentially acting in the same way the hormones your body makes. To further explain, hormones in our body work like a lock and key, hormones (the “keys”) must fill a receptor site (the “lock”) to create an action or response in the body. If you attempt to use a key that doesn’t fit identically into the lock, issues may arise. You won’t be able to open the door, the key may get stuck, or ultimately the lock may break.

The same process is true with hormone medications and bioidentical hormones aim to get around this problem of mismatched hormones by starting with a natural hormone as a base. This natural base is what distinguishes bioidentical HRT from synthetic HRT. While both are modified or manufactured in a lab (the only true “natural” hormones are those your body makes), synthetic hormones, made entirely from chemical compounds don’t communicate with our bodies in the same way. This can lead to any beneficial effects being outweighed by the potentially harmful effects due to poor communication.

How do I know if I’m in peri-menopause or menopause?

The average age of menopause is 51, but symptoms of hormone fluctuations often begin five to 10 years before menopause for most women. These hormone fluctuations can be huge from year to year and often leave women with a roller coaster of symptoms to navigate.

hormone symptoms chart image via

As this process unfolds and our bodies go into menopause, hormone levels, typically progesterone first, then testosterone, and lastly estrogen, begin to drop. This can lead to uncomfortable symptoms like hot flashes, sleep difficulties, vaginal dryness, loss of libido, joint pain and muscle aches, hair loss, mood swings, and changes in metabolism leading to weight gain. Women going through menopause are also at greater risk of osteoporosis or bone density loss due to estrogen loss, which can lead to soft bones and an increased risk of fractures.

A medical provider can prescribe a woman a variety of methods to replace the estrogen, testosterone, or progesterone they lose during menopause, including pills, patches, topical treatments, and vaginal suppositories. The most common treatment is a low dose of estrogen usually absorbed through the skin through a cream, gel, patch, or pellets. As the field of hormone replacement progresses, many advanced hormone prescribers use combinations of HRT that include specific doses of estrogen, progesterone, and/or testosterone.

At Restoration Health, we prescribe HRT based on the woman’s individual needs, body composition, and medical history. We also only prescribe bioidentical hormones, rather than synthetic formulas, as the synthetic treatments tend to come with more risks.

Pros of HRT

Hormone replacement therapy is very effective in relieving many of the symptoms women experience during menopause. Many women we treat are surprised at how much HRT can improve their daily lives. In our experience, HRT gives women their vitality back and helps them live life to the fullest.

Some of the biggest benefits or pros of HRT include:

These benefits can help women get their lives back and enter a new period of their lives with comfort and control. In fact, as recently as April 2024, the North American Menopause Society released a position statement supporting a large-scale 13-year study of 10 million (!) senior women showing these reduced health risks in menopausal women.

Pros and Cons of HRT
Pros and Cons of HRT via

Cons of HRT

Any treatment will come with risks, and HRT is no different. Unfortunately, many women may get conflicting information from their doctors or OBGYNs, not to mention their own internet research. Hormone replacement has been studied for decades, and some of the risks associated with it can include:

However, these risks have mostly been associated with high doses of estrogen and synthetic estrogens. In the case of breast cancer, HRT was found to increase the risk in women who were already at a higher risk of estrogen-dominant breast cancer. This means that HRT doesn’t cause cancer itself, but may contribute to the growth of existing cancer or to encourage tumors to grow in patients who were already at risk.

The form of estrogen chosen could also play a role in risk. But at the end of the day, it’s about how we utilize this in our bodies. For example, due to the way estrogen is broken down when it’s taken in synthetic and/or pill form, it can change how our blood coagulates or clots leading to an increased risk of blood clots throughout our body (similar to the blood clot risk with synthetic estrogen birth control).

Handling the Risks of HRT

At Restoration Health, we address risk factors before we prescribe HRT to any woman. Because our main goal is to optimize your health and prevent chronic disease, we already assess your health risks and discuss any pre-existing issues before we prescribe any treatment. Part of your overall treatment at Restoration Health will include a full evaluation and education on lowering your health risks, especially those that may be a problem during HRT.

Another way we handle the risk of HRT in patients is by starting with the lowest possible dose of hormones and tailoring the prescription to the patient based on their results. We regularly evaluate repeated hormone values through blood testing as well as the patient’s results or side effects. There’s no blanket treatment that will work for anyone, and we make sure our patients have a treatment plan that will work for them.

Finally, we conduct hormone lab levels every three to six months and evaluate cardiovascular risk factors. Alongside preventive screenings like regular mammograms and other cancer screenings, patients can generally take HRT and get the benefits from it with full peace of mind. Ultimately, when considering any treatment option, it’s important to weigh the potential risks with the potential benefits and decide what’s best for you.

Start HRT at Restoration Health

Find the hormone replacement therapy treatment you need at Restoration Health. Our team tailors each treatment plan to the patient’s specific and individual needs based on a thorough intake evaluation and ongoing monitoring. Set up an appointment today to learn more about how HRT can help you.

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