HRT or No HRT 

What is HRT

Hormone Replacement Therapy is exactly what it says, you can be prescribed estrogen, progesterone or testosterone  (HRT) to replace the hormones you are loosing.  All hormones start to decline around the age of 45 years. Most doctors may offer a blood test, but in reality it's more important to prescribe HRT  based upon symptoms. Our hormones go up and down throughout a month, so a blood test can be misleading.

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Bio-Identical Treatments

The Society of Obstetricians and Gynecologists' of Canada (SOGC) and the North American Menopause Society (NAMS) clearly states that they do not support the use of custom compounded bioidentical hormones therapy. These products do not have Health Canada approval. The only products to use are those approved by Health Canada. If you are worried about the risk of breast cancer it is important to use regulated products. Be cautious of private clinics offering expensive blood tests, supplements and compounded bioidentical hormones.

Unsupported Therapies not approved by Health Canada include,

Bi-est cream, Tri-est cream, Estriol cream, Progesterone cream, DHEA ( Dehydroepiandrosterone) tablets.

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Option and Types

Estrogen- patch, gel, tablet or spray 

Progesterone- capsule or tablet

Testosterone- cream

Click Here for Canadian Treatment Guide

Click on the Community & Resources Page for other country resources

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Side Effects and Risks

We can't talk about HRT without mentioning the 2002 Women's Health Initiative (WHI) study. Many women were alarmed at the published results of an increased risk of breast cancer. Since then many leading physicians around the world have disputed and disproved the results (See the Community & Resources) giving women the confidence to take HRT again. We must also remember that since 2002, we have more effective HRT. Unfortunately even Health Canada is still out of date with its guidance and remains cautious in its recommendations

Breast cancer risks

23 women out of 1000 are at risk regardless

 5 women out of 1000 are at risk if they have 2 units of alcohol of more per day

 24 women out of 1000 are at risk if they have obesity with a BMI over 30

 4 women out of 1000 are at risk if they take HRT - or a 0.04% risk

 

It is important to monitor any side effects, but most do settle after a few weeks.

 

Costs

If you are not covered by a health benefits plan or social program, you will be required to pay for your hormone replacement therapy. Depending upon your prescription it can from $30 to $100 per month.

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How to adjust

This is often the most challenging part of using HRT. Our symptoms can return, again blood test don't usually help, go back to monitoring your symptoms and discuss a change of dosage or product with your doctor. Also assess your general health and wellbeing. Our hormones fluctuate through our lives, perimenopause and menopause are no different.