Menopausal Hormone Therapy (MHT): What You Need to Know
What Is Menopausal Hormone Therapy (MHT)?
Menopausal Hormone Therapy (MHT) — sometimes called “bioidentical” hormone therapy — is a medical treatment designed to help women manage the symptoms and physical effects of estrogen deficiency during perimenopause and menopause.
It works by supplementing the hormones your body is producing less of during this stage of life.
Who Benefits From MHT?
MHT is most beneficial for women who are experiencing significant symptoms or physical effects of estrogen deficiency.
It is generally considered most appropriate for women who are:
- Under the age of 60, or
- Within 10 years of menopause
This is the window in which the benefits of MHT are most likely to outweigh the risks.
Women with Premature Ovarian Insufficiency (POI) may also be strong candidates for MHT.
What Symptoms Does MHT Treat?
MHT is the most effective therapy for several menopause-related symptoms and health concerns, including:
- Hot flashes and night sweats, also known as vasomotor symptoms (VMS)
- Vaginal dryness and urogenital changes
- Sleep disturbances
- Mood changes and mental health symptoms
- Joint and muscle pain
- Sexual dysfunction, including reduced libido
- Osteoporosis, helping to reduce the risk of fractures
Benefits of MHT
The potential benefits of MHT go beyond symptom relief. When used appropriately, MHT can:
- Significantly improve quality of life by reducing hot flashes and night sweats
- Protect bone health and reduce fracture risk
- Support mental health and mood stability
- Improve sleep quality
- Enhance sexual health and comfort
- Help with muscle and joint health
What Are the Side Effects and Risks of MHT?
Like any medication, MHT can come with side effects. Up to 10% of people may stop MHT because of side effects, so open communication with your healthcare provider is important.
Common side effects can include:
- Unscheduled bleeding or spotting — the most common issue; some bleeding during the first six months can be normal
- Bloating or digestive upset
- Fluid retention
- Breast tenderness
- Headaches or migraines
- Mood changes
- Skin, allergy or histamine reactions
MHT With a Naturopathic Doctor
One of the major benefits of working with a Naturopathic Doctor who can prescribe MHT is that we go beyond prescribing hormones.
We can also provide individualized support around nutrition, movement, sleep, stress management and other aspects of health during perimenopause and menopause.
In my own practice, this includes conversations about preventative health during perimenopause and how we can address some of the health risks that become increasingly important as estrogen declines, including cardiovascular health and osteoporosis.
There are also limitations to the prescribing scope of Naturopathic Doctors in Ontario. NDs are currently able to prescribe topical estrogen and topical progesterone, but not oral progesterone.
This can present a challenge when prescribing systemic estrogen to someone who has a uterus, as adequate progesterone is required to protect the endometrium from hyperplasia.
At The Root Natural Health Clinic, we work collaboratively with a Nurse Practitioner who can help close this gap by prescribing oral progesterone for patients who require it.
Should You Consider MHT?
If you’re experiencing moderate to severe perimenopause or menopause symptoms that are affecting your daily life, sleep or overall well-being, MHT may be worth discussing with your healthcare provider.
Before starting MHT, make sure you are up to date with appropriate routine health screening, such as:
- Mammography
- Bloodwork
- Colon cancer screening, when applicable
- Other screening recommended based on your age and personal health history
It’s also important to have an open conversation with your healthcare provider about your personal and family health history, current symptoms, goals and individual risk factors.
The Bottom Line
MHT remains one of the most effective tools available for managing menopause symptoms.
When it’s the right fit, many of my patients find it life-changing. The decision to use MHT should be individualized based on your symptoms, health history, preferences and potential benefits and risks.
Always consult with a qualified healthcare provider before starting, stopping or changing hormone therapy.