Why Women Shouldn’t Wait: My Top 6 Reasons to Start Hormone Replacement Therapy Early

The Dr. Tyna Show Episode 173

Bioidentical hormone replacement therapy (BHRT) is a controversial topic in women's health. But should it be? If you’re in perimenopause, menopause, or navigating hormonal imbalances, BHRT can be a lifesaver. 

There’s so much conflicting information out there — and so many women are unsure, skeptical, or even terrified of it.  

That’s why, in this episode, I’m breaking it all down for you, and sharing insights from my decades of experience as a licensed naturopathic physician prescribing BHRT to countless women and men. 

You see, unlike so many in the space, I was never scared off by the Women’s Health Initiative 2002 study that terrified an entire generation of doctors out of prescribing HRT. My colleagues and I have been prescribing HRT for decades.

HRT being safe for menopause and even prior to menopause for health optimization is nothing new, even if some doctors are only coming around to it recently. I’m glad they are finally waking up and becoming more brave. 

Tune in as I explain the benefits of hormone replacement therapy (HRT), debunk common misconceptions, and offer practical advice on how to navigate this important health decision.

In this episode, you will learn:

• Why early intervention with hormone therapy may be more beneficial than delaying treatment.
• How misconceptions about hormone therapy have affected women’s health — and the big study that got it all wrong.
• Key factors to consider when deciding whether HRT is right for you.

Let’s dive into the essentials of bioidentical hormone replacement therapy.

Disclaimer: This is for educational purposes only. I am NOT your doctor and every person is different when it comes to their risks vs benefits with HRT. Please always refer to YOUR doctor or a hormone literate doctor when it comes to decisions about what is best for you.

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What is Bioidentical Hormone Replacement Therapy?

Bioidentical hormones are compounds chemically identical to the hormones naturally produced by your body. BHRT typically refers to estrogen, progesterone, and testosterone used to supplement or replace declining hormone levels, particularly during perimenopause and menopause.

The goal of BHRT is to alleviate symptoms related to hormone deficiency, such as hot flashes, mood swings, and joint pain while reducing long-term risks related to bone and cardiovascular health.

Misconceptions About HRT: Separating Fact from Fiction

Despite evidence supporting its safety and efficacy, hormone therapy has been surrounded by controversy since the Women’s Health Initiative (WHI) study of 2002. The WHI study led to widespread fear that HRT increased risks of breast cancer and cardiovascular disease. 

However, updated research has brought many of these claims into question.

Here are some common misconceptions about hormone replacement therapy:

• HRT Increases Cancer Risk: While certain synthetic progestins used in older therapies were linked to increased risks, bioidentical hormones like micronized progesterone are much safer. Studies now suggest that estrogen, when used appropriately, could possibly reduce risks of certain cancers, particularly when combined with progesterone.
• HRT is Dangerous for the Heart: More recent studies have shown that early initiation of HRT—specifically in perimenopause—could be cardioprotective. Estrogen helps maintain vascular health and elasticity, which could reduce the risk of heart disease.
• You Don’t Need Hormones During Menopause: Some argue that menopause is a natural process that doesn’t require intervention. While it’s true that menopause is natural, the loss of estrogen can lead to numerous health problems, including joint degradation, osteoporosis, and cognitive decline. Hormone therapy could protect against these issues.

Why Early Intervention with Hormones Matters

Delaying hormone therapy can have detrimental effects. The critical window hypothesis suggests that starting HRT during perimenopause or early postmenopause offers significant health benefits, whereas starting much later may not yield the same positive outcomes.

Key benefits of early HRT intervention:

• Heart Health: Estrogen has a protective effect on the heart, which could mean reducing the risk of cardiovascular disease when started early.
• Bone and Joint Health: Estrogen plays a vital role in maintaining bone density and joint health. Women who begin HRT earlier could possibly reduce their risk of osteoporosis and related fractures.
• Brain Health: Estrogen also supports cognitive function. Studies show that early use of estrogen could reduce the risk of cognitive decline and even Alzheimer’s disease.

Practical Considerations: Who Should Consider BHRT?

Hormone therapy is not a one-size-fits-all solution. Women who are perimenopausal, postmenopausal, or experiencing significant hormonal imbalances should consider speaking with a qualified physician to evaluate their need for BHRT. Even women who are younger than the traditional perimenopausal age may be candidates for HRT if their symptoms and lab tests are suggestive of low hormonal status. 

Testing hormone levels is a critical first step in determining whether supplementation is necessary. That said, I often base my clinical decisions on SYMPTOMS and then utilize testing to track progress. Because labs can be normal and the woman in front of me is suffering. If it’s clinically indicated we don’t always need screaming low levels to justify a trial of HRT.

Key considerations before starting BHRT:

• Get Tested Early: Hormonal imbalances can begin earlier than many expect. Consider getting your hormone levels tested as early as your 30s, especially if you start noticing symptoms like fatigue, mood swings, or weight gain.
• Work with a Knowledgeable Provider: Finding a skilled practitioner who understands hormones is critical. Not all healthcare providers are well-versed in hormone therapy, so it’s essential to find one with experience in BHRT.
• Dosing Matters: Physiologic dosing is key to avoiding side effects. This may be lower doses than is standard, but not always. It’s important to work with your doctor to find the right dose for you, which will likely need to be adjusted over time.

Key Benefits of Bioidentical Hormone Therapy

For women considering hormone therapy, here are some compelling reasons to explore BHRT:

• Improved Cardiovascular Health: Estrogen helps keep blood vessels healthy and elastic, which could promote better heart function.
• Bone Density Maintenance: HRT could help maintain bone density, reducing the risk of fractures as you age.
• Enhanced Cognitive Function: Early use of estrogen could possibly protect the brain from neurodegenerative diseases like Alzheimer's and could support cognitive function.
• Improved Mood: Dropping levels of hormones can significantly impact mood. Many women during perimenopause and menopause experience depression, anxiety, and mood swings — and HRT could help. 
• Reduction in Hot Flashes and Night Sweats: HRT helps with vasomotor symptoms, including hot flashes and night sweats, which can severely disrupt daily life and sleep.
• Better Skin and Tissue Health: Estrogen is crucial for maintaining skin elasticity and hydration, as well as the health of other tissues like gums and muscles.
• Sexual Health and Urinary Function: HRT could support sexual health by addressing issues like vaginal dryness and urinary tract infections caused by tissue atrophy.

Who Should Avoid BHRT?

Not everyone is an ideal candidate for BHRT. Certain medical conditions, such as a history of blood clots or certain types of cancers, may preclude the use of hormone therapy. It’s essential to discuss your full medical history with your doctor before starting HRT.

Additionally, women with severe metabolic dysfunction or high levels of inflammation may need to address these issues before safely beginning hormone therapy. This is where I LOVE the consideration of GLP1 agonists done in a personalized dosing strategy that I discuss inside my GLP-1s Done Right University course.

Benefits Of Bioidentical Hormone Replacement Therapy

Bioidentical hormone replacement therapy can be a game-changer for women experiencing the symptoms of hormonal decline. Early intervention could be key to reaping the full benefits of HRT, which include protecting heart health, bone density, and cognitive function. By getting tested early and working with a skilled provider, you could improve your overall quality of life during menopause.

In summary, here are the key takeaways:

• Early intervention with HRT could protect heart, bone, brain health and so much more!
• Common misconceptions about hormone therapy have been debunked by recent research. Check out the work of Dr. Avrum Bluming, Estrogen Matters, for more.
• Working with an experienced healthcare provider is crucial to personalizing your hormone therapy plan.
• If you’re interested in learning more about how to optimize your health during menopause, consider speaking with a hormone-savvy doctor and exploring the options available to you.

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Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.