Considering starting Hormone Replacement Therapy Before Menopause?

Bioidentical Hormone Replacement Therapy (BHRT) is a powerful tool in managing hormonal imbalances that occur with aging. Many women assume that hormone therapy is only necessary once menopause has fully set in. However, starting BHRT before menopause—during perimenopause or even earlier—can provide significant benefits and improve long-term health outcomes.

By proactively addressing hormonal shifts, women can experience a smoother transition into menopause and avoid many of the associated symptoms.

Menopause is officially diagnosed when a woman has gone 12 consecutive months without a menstrual period, typically occurring between ages 45 and 55. However, perimenopause begins approximately 8 years before the cessation of the menstrual cycle.  During this time, estrogen, progesterone, and testosterone levels begin to fluctuate, which leads to the variety of symptoms (irregular periods, mood swings, sleep disturbances, weight changes and reduced energy levels) that some women experience.   And let’s not forget about the unseen, often unfelt physiological changes that are occurring in your bones, your heart and your brain (to name a few).

If you are struggling during the perimenopausal years, good news! You do not need to wait until menopause to stabilize your hormones.

At Windhorse Woman, for those who want to use hormones, we use bio identical hormones, which are molecularly identical to those hormones produced by your body.  Each woman is different and her needs are completely tailored to her goals.

Benefits of Starting BHRT Before Menopause

1. Alleviation of Perimenopausal Symptoms

  •          Reduction of hot flashes and night sweats
  •          Improved sleep quality and reduced insomnia
  •          Enhanced mood stability and reduced anxiety/depression
  •          Increased energy levels and reduced fatigue
  •          Fewer migraines and headaches related to hormonal fluctuations

2. Improved Metabolic Health

  •          Easier weight management and reduction in abdominal fat
  •          Enhanced muscle mass and strength
  •          Improved blood sugar regulation and reduced risk of insulin resistance

3. Preservation of Bone Density

  •          Reduced risk of osteoporosis and bone fractures
  •          Improved calcium absorption and bone strength
  •          Maintenance of joint health and reduced inflammation

4. Cognitive and Mental Health Benefits

  •          Improved memory and cognitive function
  •          Enhanced focus and mental clarity
  •          Reduced risk of brain fog and forgetfulness
  •          Lower likelihood of developing neurodegenerative diseases such as Alzheimer’s

5. Enhanced Sexual and Reproductive Health

  •          Increased libido and improved sexual satisfaction
  •          Reduction in vaginal dryness and discomfort during intercourse
  •          Balanced menstrual cycles with less severe PMS symptoms
  •          Reduced risk of developing severe postmenopausal symptoms

6. Better Cardiovascular Health

  •          Improvement in cholesterol levels and ratios
  •          Support for healthy blood pressure levels
  •          Reduced risk of heart disease and stroke
  •          Improved circulation and vascular function

7. Skin, Hair, and Overall Aging Benefits

  •          Increased skin elasticity and reduced wrinkles
  •          Improved hydration and overall skin health
  •          Healthier hair with reduced thinning or hair loss
  •          Stronger nails and reduced brittleness

Sounds like the Holy Grail, right?  Truth be told, HRT really can enhance your life span and your health span, but of course it’s not right for everyone.

If you are weary of hormones due to poor experiences with birth control pills, just keep in mind that oral contraception pills are typically a much bigger dose of hormones (and usually synthetic), compared to BHRT.  So that’s one reason why a woman may feel better transitioning to BHRT.

That said, I’m not knocking birth control pills, they can be extremely effective for the disruptive loop ovulation process that occurs in peri-menopausal women. Plus, a major upside of birth control pills, is that they provide contraception (mainly from the progestin), which BHRT does not.  And while the chances of pregnancy is much smaller in a woman over 45, the consequences are more abundant.  I tell women that pregnancy is possible until they are over 45, or have not had a period in over a year.

Another plus, there are more oral contraceptive options today, with lower estrogen (even bio identical!) dosages, which is great because that will decrease the risks of blood clots, while still controlling hormonal shifts, which cause the heavy periods and mood changes. There is also the progestin only pill, called drospirenone, (trade name Slynd), which is not associated with blood clots. It won’t help with hot flashes, but because it’s very effective at suppressing ovulation, it also can prevent erratic ovulation-related mood swings and control bleeding while also providing contraception.

So, there are plenty of options out there for women, which are economical and widely available, and that is always the goal. I generally prefer to start women on BHRT because it can be tailored to her changing body, the hormone concentrations are smaller and can be titrated.  Again, the downside is that BHRT does not offer birth control.

Take home message: You have options, and that is what we want for women.

Your body is changing, and it will keep changing. 

Your risks and benefits of BHRT or oral contraception may be different in 2 years, or in 10 years compared to right now. As your doctor, and your prescriber, my promise to you is that I will evolve with you and your goals and needs, as well as with the current medical research on the safety and efficacy of prescribing hormones.

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