Looking for natural hormone therapy alternatives? Read the article and let yourself be guided by the controversial history of this therapy. Equip yourself with the necessary knowledge to make your own decision.

Natural hormone therapy addresses hormone imbalances, perimenopausal symptoms, and menopausal symptoms. By adopting personalized and informed strategies, women can overcome the challenges of menopause with confidence, guided by the latest advances in natural hormone therapy.

Continue reading to explore more information about natural hormone therapy. Discover alternatives for menopause management and make informed decisions.

Natural hormone therapy

The use of non-synthetic hormones or hormone-like substances, usually derived from plants, describes natural hormone therapy.

Lifestyle changes and herbal supplements, used to alleviate the symptoms of hormonal imbalances during menopause, are considered natural hormone therapy alternatives and are non-pharmaceutical methods.

Alleviating the symptoms of menopause by regulating the low levels of estrogen and progesterone in the female body can be done through hormone replacement therapy (HRT). Menopause symptoms can include hot flashes, night sweats, mood swings and vaginal dryness. Menopause usually occurs in women between the ages of 45 and 55, when menstruation stops due to hormonal changes. HRT usually involves taking estrogen and progesterone together, or just estrogen if the uterus has been removed.

Hormone replacement therapy

Depending on individual health needs and risk factors, there may be different types of hormone replacement therapy (HRT).

Supplementing the declining levels of estrogen, progesterone and testosterone produced by the ovaries before menopause can be done through hormone replacement therapy (HRT). It thus increases the life expectancy of women, as the therapy helps alleviate the symptoms of menopause caused mainly by the loss of estrogen.

HRT comes in different forms, containing estrogen, progestin, or both, and can be given by different methods, such as tablets, patches, gels, or creams.

The choice of HRT depends on factors such as whether a hysterectomy has been performed, the stage of menopause, and personal preferences.

The two main types of treatment plans are cyclical and continuous HRT, with variations in how hormones are taken and when. 

Bioidentical hormone therapy

Bioidentical hormone therapy (cBHT) refers to a treatment approach where hormones are custom-compounded to match those naturally produced by the body. 

There are two types of BHT: regular and compounded. Regulated bioidentical hormones (rBHRT) are derived from plants and available through standard prescriptions, while compounded bioidentical hormones (cBHRT) are customized based on blood test analysis but lack regulation and are not recommended by the British Menopause Society.

Despite the perception that cBHT is "natural," it still involves biochemical synthesis and can vary in potency. Concerns arise from its lack of Food and Drug Administration (FDA) oversight, leading to inconsistencies in quality and efficacy. Recent recommendations emphasize restricting cBHT use to individuals with specific allergies and ensuring standardized information and warnings are provided. These guidelines aim to align cBHT practices with established safety and efficacy standards set by professional medical organizations.

Safety considerations

Treatment guidelines

Menopause symptoms, age and general health are the main factors that are taken into account when deciding to start hormone replacement therapy, considering both the advantages and disadvantages of the therapy.

The ideal in terms of administration method is to use the lowest effective dose and to have the shortest time necessary to control the symptoms.

Individual factors such as the risk of blood clots or the presence of a uterus are factors that are taken into account when deciding the method of administration (oral or transdermal) and the type of hormones (estrogen-only or combined with progestin).

Assessing improvement in symptoms and following up on any side effects are part of monitoring therapy. Check-ups are done regularly to reassess the need for continued treatment and to promote healthy habits.

Weighing ongoing symptoms against potential risks helps to decide between continuing or stopping therapy. Even though discontinuation may lead to the recurrence of symptoms and that the approach to discontinuation varies, the final decision is the person's.²

Choosing the right hormone replacement therapy (HRT) regimen is essential, but clear guidance is lacking. While personalized approaches based on genetic factors may improve HRT's effectiveness and safety in the future, caution is advised against using compounded 'bioidentical' hormones due to the lack of scientific evidence supporting their safety and efficacy.

Advantages of HRT include reduced risk of coronary heart disease (CHD) and mortality, relief from menopausal symptoms, and lower risk of osteoporotic fractures. However, disadvantages include increased risk of breast cancer and amplified risks of CHD and mortality in older women. The complexity of selecting an appropriate HRT regimen adds to challenges, leading to a decline in HRT use in recent years.

Contemporary studies ³ highlight HRT as a valuable therapeutic option for managing menopausal symptoms and associated conditions. Estrogen-based treatments significantly improve the quality of life for women experiencing symptoms, and various options offer flexibility in dosing and efficacy. Clinical trial data suggest that initiating HRT before age 60 or within 10 years of menopause reduces all-cause mortality, lowers the risk of CHD and fractures, and may protect against dementia.

Benefits and risks

Although the use of the therapy experienced initial popularity after the Women's Health Initiative (WHI) study, a considerable decline followed, with popularity fluctuating over time precisely because of new discoveries.

The initial terminology of "hormone therapy" became "hormone therapy for menopause", gaining new notoriety.

As considered in Lobo's study 1, the timing of HRT initiation, particularly concerning the onset of menopause, in the prevention of coronary heart disease (CHD) and cognitive decline may have a significant impact on its effectiveness. Basic research provides a body of evidence, from animal studies and clinical trials, to suggest that initiation of HRT may confer greater benefits in terms of cardiovascular health and cognitive function if it occurs closer to the onset of menopause.

Recent professional research highlights the efficacy and safety of hormone replacement therapy for the relief of menopausal symptoms in women, particularly at or near the onset of menopause, taking into account factors such as cardiovascular risk and breast cancer when prescribing HRT, with suggestions for types specific therapy based on individual risk profiles.

Importance

It is important to emphasize that there is controversy and uncertainty regarding the use of risk assessment tools and the management of women at higher risk of breast cancer. Moreover, public guidelines do not recommend HRT in women without specific symptoms, the debates in the field are still ongoing. Although hormone replacement therapy can help alleviate menopausal symptoms, it also comes with certain risks that should be much better highlighted.

These risks range from minor side effects, such as breast tenderness and mood swings, to more serious ones, such as blood clots and cancer. However, in young, healthy women, the risks are usually low and the benefits may outweigh them. It is therefore considered very important to carefully assess the balance between these risks and benefits regarding HRT, based on comprehensive risk data, when a decision is to be made, precisely so that it is made in the knowledge of the case. Research indicates that HRT can be a cost-effective option despite the risks, and can improve overall quality of life, especially for younger women.

Alternatives 

When hormonal therapy is not an option, several non-hormonal treatments can alleviate menopausal symptoms. These include selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, anticonvulsant medications like gabapentin, and oxybutynin targeting specific pathways. For genitourinary symptoms, low-dose vaginal estrogen or alternatives like intravaginal dehydroepiandrosterone (DHEA) and ospemifene are effective, along with vaginal lubricants and moisturizers.⁴

Lifestyle factors 

Lifestyle factors refer to changes in daily habits and practices that can help manage hormonal fluctuations and alleviate menopausal symptoms. These include maintaining a healthy diet rich in nutrients, engaging in regular exercise, ensuring adequate sleep, and considering natural remedies like phytoestrogens, black cohosh, evening primrose oil, maca root, acupuncture, traditional Chinese medicine, and mind-body approaches such as mindfulness, yoga, and cognitive-behavioural therapy. These lifestyle adjustments offer alternatives to hormone replacement therapy (HRT) and can help individuals effectively manage menopause symptoms while promoting overall well-being.

Summary

Natural hormone therapy involves the use of non-synthetic hormones derived from plants or other natural sources to alleviate the symptoms of hormonal imbalances during menopause. Hormone replacement therapy (HRT) is considered to be a common alternative for relieving menopausal symptoms by regulating abnormal levels of estrogen and progesterone. It is known that there are different types of HRT available, including different forms and combinations of estrogen and progestin, depending on a woman's individual health needs and preferences. 

Despite the fluctuating popularity of HRT, recent studies emphasize its effectiveness and safety, especially when initiated in early menopause. Although HRT comes with certain risks, the decision to start or the decision to continue treatment should be carefully weighed based on individual risk factors and preferences. Lifestyle adjustments, such as maintaining a healthy diet and regular exercise, along with non-hormonal alternatives such as SSRIs and vaginal estrogen, offer additional options for managing menopausal symptoms and improving women's quality of life.

FAQs

Does natural hormone replacement therapy work?

There is no evidence that hormones marketed as "bioidentical" and "natural '' are more effective than hormones used in traditional hormone therapy.

Is there an alternative to hormone replacement therapy?

Antidepressants such as selective serotonin receptor inhibitors (SSRIs) are the most commonly recommended first-line treatment for hot flashes in people who cannot take estrogen.

Does natural hormone replacement cause weight gain?

Some patients may experience a bit of weight gain at the beginning, but the therapy is not associated with hormone replacement and may result from hormonal imbalance.