One of the very nuanced and individualized conversations that I regularly have with folks is around the use of hormone replacement therapy (HRT). There’s a lot to consider, discuss, and reflect upon. The following questions provide a sample of what’s involved in the conversation.
- What treatment goals do we expect HRT will help us achieve?
- If HRT is started, how long until we expect to see your symptoms improve?
- Is HRT safe for you?
- Do you have any contraindications that preclude you from using HRT?
- What type(s) of HRT are we considering for you?
- Progesterone alone (without estrogen)
- Estrogen alone (without progesterone) — *only appropriate if you do not have a uterus, otherwise progesterone must also be given
- Estrogen + Progesterone
- Estrogen can be taken orally or applied transdermally as a patch or gel – which option is best for you?
- Progesterone can be taken orally or administered as a Mirena IUD – which option is best for you?
- Local vulvovaginal estrogen — *applied as a vaginal tablet or cream
- Why might we choose local estrogen therapy over systemic estrogen therapy?
- If several options exist for safe and effective HRT regimens in your case…
- Which regimen will be most practical for you?
- Which regimen will be most cost-effective for you?
- What risks are associated with the use of HRT in your case?
- Have we completed a 10 year cardiovascular disease risk calculator?
- Have we completed a 5 year breast cancer risk calculator?
- Do you understand how your baseline risks may be impacted by the addition of HRT?
- What side effects are expected when using HRT?
- How long might HRT be continued?
- How often will we check-in and evaluate your continued need for the therapy?
- Have we completed basic health screening prior to starting HRT?
- e.g. cervical/breast/colon cancer screening as per provincial guidelines, lab assessment through LifeLabs, blood pressure measurement, etc.
Need support?
Hormone replacement therapy (HRT) can be a wonderful therapy when careful consideration is given to its use. The conversation is a long one, and I’m here for it! It’s also important to remember that HRT is never the one and only treatment option, and that’s where the vast toolkit of naturopathic medicine really shines.
If you’re curious to learn more, and would like to have an open conversation about HRT in the context of your unique health story, I’m accepting new patients in BC and would love to meet you 🙂
**Please remember that this article is meant for educational purposes only and should not be viewed as medical advice.
Photo Credit: Centre for Ageing Better on unsplash
