Key updates in HRT that should be part of your conversation on midlife health planning

Recent developments by the FDA have led to planned revisions in HRT (Hormone Replacement Therapy) labelling in the United States, specifically the removal of former health warnings. Although these updates have not yet been adopted in the UK, this represents a significant shift in prescribing practices for HRT within the US, reflecting robust new research.

As a health and wellness professional, I frequently chat with clients, colleagues, and my own  girlfriends regarding the perceived risks associated with HRT. It is encouraging to observe that current evidence supporting the safety of HRT for many women is being increasingly recognised.

Previous health warnings were based on studies conducted over two decades ago; these findings have since been partially refuted, largely because of advancements in hormone formulations and the development of alternative methods of administration.

Modern bio-identical hormones are associated with markedly fewer adverse effects compared to older synthetic versions. Additionally, the use of oestrogen pessaries, rather than oral preparations, may be beneficial for treating specific menopausal symptoms while minimising hepatic metabolism (ie via the liver) —this can be particularly relevant for individuals at increased risk of hormone-driven breast cancer.

It is important to note, however, that vaginal pessaries do not significantly elevate systemic oestrogen levels, which would otherwise benefit bone health, for example.

Further, outcomes related to HRT are influenced by the timing of starting treatment relative to the onset of menopause, with earlier commencement generally resulting in improved results.

HRT has been shown to reduce the risk of certain cancers, blood clotting or cardiovascular events, as well as hormone-related migraines. While it may slow bone density loss, HRT does not reverse established osteoporosis.

When prescribed at appropriate dosages and in suitable forms, HRT offers numerous benefits, including the alleviation of anxiety, enhancement of sleep quality and mood, and improvements in libido and sexual function.

In summary, HRT should neither be categorically dismissed as unsafe nor treated as a universal solution. Instead, it ought to be regarded as a personalised, nuanced component within a comprehensive approach to menopausal symptom management and healthy ageing.

If you're navigating your midlife and want to know more about how  nutritional therapy and coaching can help you, get in touch.

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