Menopausal Hormone Replacement Therapy: What Every Woman Needs to Know

Blog Post by Coach Julie

NCI Certified Nutrition Coach and Certified Mindset Coach
Specializing in Gut Health and Women's Health

What Is Menopausal Hormone Replacement Therapy?Menopausal Hormone Replacement Therapy (MHRT), often referred to simply as HRT, involves the use of estrogen or a combination of estrogen and progesterone to relieve symptoms of menopause and improve long-term health outcomes. It’s one of the most effective treatments for managing menopausal symptoms—yet it remains widely misunderstood.
Common Menopause SymptomsAs estrogen levels decline during perimenopause and menopause, women may experience:

• Hot flashes and night sweats
  
• Mood changes
  
• Vaginal dryness
  
• Sleep disturbances
  
• Brain fog and fatigue
  
• Bone loss
  
• Increased abdominal fat
  

According to the North American Menopause Society (NAMS), over 80% of women will experience some of these symptoms, and for many, they can last for a decade or more.

Is MHRT Safe? What the Research Really SaysFor years, MHRT was overshadowed by fears stemming from the 2002 Women's Health Initiative (WHI) study, which suggested increased risks of breast cancer and heart disease. However, subsequent reanalysis of the data has clarified that MHRT is actually safe and beneficial for the majority of women, especially when started early in the menopausal transition.
Key Findings:

• A 2017 review in JAMA found that women who started hormone therapy before age 60 or within 10 years of menopause had reduced risks of heart disease and mortality.
  
• The NAMS 2022 position statement confirms that for healthy women under age 60, or within 10 years of menopause, the benefits of hormone therapy outweigh the risks.
  
• A 2020 study in the American Journal of Public Health suggested that up to 90,000 premature deaths could have been prevented if women had continued using MHRT.
  

Dr. Mary Claire Haver’s PerspectiveDr. Mary Claire Haver, OB-GYN and founder of The Galveston Diet, is a vocal advocate for hormone therapy in midlife women. She stresses that:
"We now have clear, evidence-based data showing that hormone therapy is not only safe but extremely beneficial for women when used appropriately."
Dr. Haver recommends that women discuss MHRT with their healthcare provider early in their menopause journey, especially if symptoms are interfering with quality of life.

Benefits of MHRTFor most women, MHRT offers a wide range of health benefits:
Relief from Hot Flashes and Night SweatsEstrogen therapy is the gold standard treatment for vasomotor symptoms (like hot flashes), which affect up to 75% of women in menopause.
Improved Sleep and Mental ClarityHormone therapy has been shown to improve sleep quality and reduce brain fog, helping women feel more like themselves again.
Bone Health SupportPostmenopausal women are at increased risk for osteoporosis. Estrogen helps maintain bone density and reduce fracture risk, according to a 2019 review in Osteoporosis International.
Heart Health and LongevityWhen started early, MHRT has been linked to reduced coronary artery disease risk and increased life expectancy in women.
Improved Genitourinary HealthEstrogen helps with vaginal dryness, painful intercourse, and urinary symptoms—issues that can severely affect intimacy and quality of life.

Who Should Avoid MHRT?While MHRT is safe for many, there are exceptions. Women with a history of the following should discuss alternatives with their doctor:

• Breast cancer
  
• Active liver disease
  
• Blood clots
  
• Undiagnosed vaginal bleeding
  

Final Thoughts: Empowered, Not AfraidIt’s time to shift the narrative. MHRT is a safe, science-backed tool for improving quality of life, longevity, and overall health for millions of women navigating menopause.
As Dr. Mary Claire Haver says:
“Menopause is not the end—it's a new beginning. Women deserve to have the tools and knowledge to thrive through this stage of life.”