What You Need to Know if You Are Considering Hormone ReplacementHave you just had it with the anxiety, irritably, lack of sleep, brain fog and weight gain due to hormone imbalances but are afraid to seek treatment? Hormone imbalances can drastically affect the quality of your life. What if the benefits outweighed the risks? If so, is hormone replacement something you are open to investigate to determine if it is right for you?

Depending on what stage of life you are in and your underlying medical conditions, lifestyle, and genetics, some of these risks could apply to you. These are some of the things you may be suffering with during different stages and there is always cross over.

Hormone Replacement Therapy printed on a graphicPMS stage

  • Menstrual migraines
  • Cramps
  • Heavy or irregular bleeding
  • Infertility
  • Mood swings
  • Fibrocystic breasts
  • PCOS and/or Ovarian cysts
  • Bloating
  • Fluid retention
  • Breast tenderness


  • Anxiety
  • Irritability
  • Impatience
  • Insomnia
  • Growth of and cysts of the breast
  • Heavy, light, more frequent or less frequent periods
  • Night sweats


  • Hot flashes
  • Night sweats
  • Dry eyes, skin and vagina
  • Poor memory
  • Mental fog
  • Anxiety and depression
  • Mood swings
  • Loss of libido and sexuality
  • Increase in bone loss – osteoporosis
  • Increase in cardiovascular disease
  • High cholesterol
  • Decrease in energy and motivation

All stages

  • Anxiety
  • Irritability
  • Lack of Sleep
  • Brain Fog
  • Weight Gain

Decision making process

Furthermore, ask yourself: How severe are the symptoms and how is this impacting my life?

Therefore, no matter what age or what stage of life you are in only you can determine how it is impacting your life.

  • Many women suffer a loss of self-confidence and self esteem feeling as if their minds and bodies are betraying them.
  • Relationships with family, friends and coworkers can suffer due to the mood swings and some people may just label you as unstable or want to avoid you during those times of the month or even more.
  • Some may find it is impacting their self fulfilment since they may be held back from doing the things they want to do.
  • Symptoms can be debilitating.
  • Work and job performance could be suffering as well as how you spend your leisure time.
  • Accidents and poor decision making can occur due to lack of sleep
  • Overall health may suffer since hormone imbalances impact a lot of medical conditions.

There is a risk of doing nothing

What are the risks of hormone replacement and is it a risk worth taking even for a short period of time? Let’s explore some of the risks and bust the myths.

Weight gain

Weight gain is a myth. Balanced hormones don’t cause weight gain. Here are factors that can cause weight gain

  • Too much or too little estrogen
  • Not enough progesterone to balance estrogen
  • High or normal estrogen with not enough progesterone lowers thyroid which lowers metabolic rate
  • Dis-stress on your mind and body will elevate cortisol the stress hormone which will cause metabolic issues and increase fat storage.

Breast Cancer

Women not on hormones can get breast cancer and so do women on hormones. Lifestyle has a greater influence on breast cancer and mitigating as many risk factors as possible can lower your risk. Here is what studies showed:

The Women’s Health Initiative (WHI) study subjects were women whose average age was 63, 10 years past menopause and used high doses of synthetic estrogen and progestins.

  • This study has been reevaluated and it showed benefits if hormone replacement started before age 60 within 10 years of menopause.
  • Women on estrogen alone had 7 FEWER cases of breast cancer and the decreased risk of 21% less cases persisted over 13 years of follow up
  • The risk of breast cancer was less in the first 2 years for women treated with hormones

E3N EPIC French Cohort Study subjects average age was 40-45, over 80% of the women used bioidentical hormones.

  • The risk of breast cancer was lower in the first 2 years, the same as the general population in the first 5 years and rises to 1.26 thereafter between 5 and 10 years.


The route of administration of hormones affects the risk of clots.

  • Oral estrogen increased the risk of clots
  • Multiple studies showed that transdermal estrogen given through the skin had negligible risk of clots.

Cardiovascular disease

Cardiovascular disease is the number 1 cause of death in women and is 17 times more prevalent than breast cancer. The American Heart Association acknowledged that the timing of giving hormone replacement therapy could lower the risk of heart disease and early intervention may prevent cardiovascular disease.

  • SWAN study showed that higher estrogen levels were associated with less buildup of plaque in the carotid arteries.
  • Removing ovaries that make estrogen and progesterone is associated with higher risk of cardiovascular disease.
  • Early menopause is associated with higher risk of cardiovascular disease.
  • Menopausal symptoms such as hot flashes, sleep disturbance, depression, increased cholesterol, visceral fat (around organs) and pericardial fat (around heart) are associated with a higher risk of heart disease.
  • WHI showed no statistical difference in risk of heart disease.
  • Studies now support the use of hormone replacement if given before age 60 and within 10 years of menopause.

All hormones are the same

Hormone side effects can be very different depending on the type and how they were administered.

  • The E3N study showed the that the risk of developing breast cancer using bioidentical estrogen plus natural progesterone is lower in the first 2 years, about the same in the first 4-5 years and rises to 1.26, thereafter.
  • However bioidentical estrogen and synthetic progestogen has an increased risk of 1.36 in the first 2 years, 1.56 in the first 4-5 years and increases to over 1.79 after 6 years.
  • Synthetic progestins decrease HDL the good cholesterol and natural, bioidentical micronized progesterone raised it.
  • Progestins increased coronary artery spasm, progesterone relaxed the arteries.

While every study has flaws, the bulk of the evidence when broken down into subgroups showed that taking estrogen and natural, bioidentical micronized progesterone before age 60 and withing 10 years past menopause, with estrogen given through the skin, significantly decreases the risks of clots, breast cancer and heart disease.

In conclusion, doing nothing poses a risk and I cannot honestly say that taking hormones has no risk. One must weigh the quality of their life and their risk factors for breast cancer, clots, heart disease, osteoporosis, metabolic disorders, depression, and other collateral effects of the lack of hormones to decide if hormone replacement is right for them. Consult with your doctor and seek the opinion of a functional medicine doctor who is well versed in hormone replacement and holistic care to help you decide if hormone replacement is right for you.