Menopause without HRT: Is it a ‘natural’ solution?
This article discusses a Hormone Replacement Therapy, key risks, considerations and items to discuss with your healthcare professional before deciding whether to use HRT medication.
Each individual and their circumstances is unique, so we can’t make any recommendations. The contents of this article are not to be taken as medical advice, but may help when speaking to your doctor.
A common question
A lot of women I talk to often ask if they can go through menopause ‘naturally’ instead of taking hormone replacement therapy. The honest answer is: “It is a personal choice.” However you must consider the risks, your lifestyle and diet to support your heart, bones and brain to thrive in the later stages of life. Here we will explore these considerations.
As an aging population it is important that we consider not only our lifespan i.e. how long we live but also our healthspan. The recognition of the concept healthspan has increased in popularity in recent years and a common definition of healthspan is:
‘healthspan is the period of life spent in good health, free from the chronic diseases and disabilities of aging’ (Matt Kaeberlein, 2018)
As ‘health’ can be quite a subjective term, what does it mean to be ‘healthy’ in postmenopause and beyond, and what are the health factors we need to consider when we transition through menopause naturally?
Consider the health risks
There are three major health risks associated with menopause for your heart, bones and brain. If you choose to transition through menopause naturally, please discuss these items with your doctor.
Heart health
The natural decline in oestrogen can lead to heart related issues such as high cholesterol, blood pressure and an increased risk of cardiovascular disease.
To manage these risks and maintain a healthy heart you might benefit from:
Regular check ups to measure cholesterol, blood pressure and general heart health
Include heart healthy foods in your daily diet such as extra virgin olive oil, nuts and seed, avocado, oily fish
Manage your stress levels with the help of breathe work, walking in nature, meditation
Include daily movement that makes you happy e.g. walking, yoga, pilates, swimming, cycling, dancing
Limit or omit recreational substances such as alcohol and smoking
Bone health
Lower amount of oestrogen leads to reduced strength in our bones and can lead to osteoporosis. Osteoporosis is the most common disease associated with aging and can considerably reduce a person's quality of life.
To maintain strong bones during the menopause transition and beyond, it is important to consider the following:
Eat enough calcium to support bone maintenance e.g. dairy, soya, green leafy vegetables, nuts, fish containing bones such as sardines
Include a source of protein at each meal. Variety is important so consider plant proteins such as beans, lentils, tofu, nuts and seeds as well as animal proteins
Take a vitamin D supplement - 1000IU per day is a standard dose. You may need more or less than this depending on your exposure to sunlight. The best way to find out is to consult your doctor and test.
Do some form of strength/impact training 2-3 times per week e.g. weights, pilates
Limit recreational substances such as alcohol and smoking
Brain health
A reduction in Oestrogen increases our risk of age related dementia. To reduce this risk it is important to consider:
Eating a balanced diet with plenty of healthy fats and fibre
Get quality sleep
Manage stress
Move daily
Do brain training exercises such as using your opposite hand to do tasks, learn a new skill/language, crossword puzzles etc
Limit recreational substances such as alcohol and smoking
Make an informed choice
The menopause transition is natural and every person can choose whether to take HRT. Whether or not you take HRT, it’s important to involve your doctor in the decision, track your symptoms and test for your key markers to continue to make informed choices throughout the transition.
You may need to pay closer attention to your diet and lifestyle but these changes bring better mental health, clarity and wellbeing and will definitely be worth it in the long term (with or without HRT).