hotflash inc.: should people in menopause be on hormone therapy to prevent disease?

unfortunately, menopause hormone therapy, a.k.a. hrt, has become another polarizing topic of our times. on one hand, you have the lingering chill and fear from overblown cardiovascular and breast cancer risks that came out of the deeply flawed women’s health initiative hormone therapy trials in 2002. on the other, you have a major push for hormone therapy, not just to treat symptoms, but as a cure-all and preventive for almost everything that might ail us. and in the middle, you have a lot of doctors who don’t know much about menopause treatment, and people going through it who don’t know who to believe or where to turn.

evidence shows hrt decreased risks for type 2 diabetes

the north american menopause society (nams) released updated guidelines for doctors over the summer, which helps cut through some of the narrative.

nams generally sticks to a “with symptoms” criteria for prescribing hormone therapy, which is backed up by the u.s. preventive services task force , an independent and volunteer panel of national experts in disease prevention and evidence-based medicine, that does not recommend menopause hormone therapy for primary disease prevention in their latest systemic evidence review recently published in jama network .  

but still i wonder, isn’t it possible that the evidence will overwhelmingly tilt toward prevention and longevity in the future, and that by waiting for it, we might be missing out now? after all, as ahead-of-the-curve canadian naturopathic doctor lara briden writes in her book, hormone repair manual , the idea of “good gut bacteria” was once derided as pseudo-science — yet now, everyone is obsessed with the microbiome.

not every woman needs hrt

i put the prevention question to that rare practitioner who works in both the mainstream and integrative worlds, dr. suzanne gilberg-lenz. an obstetrician-gynecologist, board-certified in integrative and holistic medicine and a clinical ayurvedic specialist practising in beverly hills, she’s also author of the new book menopause boot camp: optimize your health, empower your self and flourish as you age .

ann marie mcqueen is a journalist with 25 years of experience covering health, wellness, science and more, and when she realized she was in perimenopause five years ago, she decided to make this transition her beat. she has since become a global expert on the subject through her platform hotflash inc. , where she helps people navigate the gap between transitional and holistic treatments with evidence and experience-based research. she will be writing regularly on all things related to menopause and mid-life.