Is Hormone Replacement Therapy Right for You?


Published:

If you’re like many women, you’re probably confused by the conflicting information about hormone replacement therapy. Whether you fall in the traditional or alternative medicine camp, or somewhere in between, it’s important to educate yourself about your options and what works best for your body and lifestyle.

What is HRT?

HRT is a hormone — estrogen, progesterone or a combination — used to supplement the hormones no longer made by the ovaries after menopause.

“If a woman has a uterus, she needs both,” says Dr. Lisa Grana, a Fellow of the American College of Obstetricians and Gynecologists at Triangle Physicians for Women in Cary. “Without progesterone, the lining can get too thick and she can be at risk for endometrial cancer. If she’s had a hysterectomy, she may only need estrogen.”

Estrogen comes in pill, spray and transdermal (gel or patch) forms. Progesterone comes in combination pills with estrogen, as a patch combined with estrogen, and as a compounded cream. Bioidentical hormones are chemically identical to hormones the body produces.

These hormones, both synthetic and bioidentical, are available either in a prescription form or from a compounding pharmacy.

“Some people believe compounded is safer. That’s not necessarily true,” Grana says. A prescription is Federal Drug Adminstration-approved and has gone through rigorous testing, whereas compounded forms have not had FDA testing and approval.

Benefits

HRT alleviates menopausal symptoms. “Women use it to regain their quality of life, if their symptoms are so severe it impacts their daily functioning,” says Anna Garrett, a board-certified pharmacotherapy specialist, Certified Intrinsic Coach, certified valuations specialist and chief “mojo” officer at DrAnnaGarrett.com.

HRT helps prevent development of osteoporosis, vaginal dryness and pain with intercourse, and it promotes bladder and vaginal health, Grana says. If it’s started at the time of menopause, it may help prevent heart disease and dementia.

Symptoms

Some women experience no symptoms, or their symptoms are not debilitating, Grana says.

Cary mom Laura Heinlein thought about HRT, but never felt a need for it, even though her doctor recommended and encouraged it. “I had about eight months of serious symptoms — losing my temper, confusion, word loss, bad night sweats,” Heinlein says, but “it wasn’t so debilitating that I couldn’t handle it.”

Heinlein has adapted to hot flashes by wearing short sleeves, even in winter, and bringing a sweater or jacket. She also cranks up the air conditioning, if possible.

Other women have very severe symptoms. “In the U.S., we’re exposed to so many compounds in the environment that mimic estrogen in our bodies, attaching to estrogen receptors and blocking the action of estrogen in our bodies,” Garrett says. “We live in a chronically stressed out way, which causes our body to make high amounts of cortisol, which impacts hormone function,” she says.

Teresa McCarthy of Swannanoa had a full hysterectomy in 1994. While estrogen cured her hot flashes, she gained weight and her libido dropped. After 15 years, she stopped taking HRT to let her body rest.

The hot flashes returned, but with them came a sensation like electricity surging through her body that made her stop doing everything until it passed. She began a bioidentical hormone replacement therapy (BHRT) in 2012, and after six weeks, felt better.

“Hot flashes were gone, my energy level was up and my outlook on life was great,” McCarthy says, adding “My libido is back!”

Drawbacks

The primary drawbacks to HRT may be increased risks for stroke, blood clots or breast cancer, Grana says.

The cost can be relatively high, whether bioidentical or synthetic, and some women don’t tolerate it well, especially if it’s not dosed correctly, Garrett says. But for many women, the pros make it worth the effort.

“There’s not a ton of cons to HRT, although there’s that subtle, low-grade fear and anxiety that if you go down the synthetic HRT road, you don’t know if you’re doing some harm to your body,” Garrett says. “This can also be true if you take BHRT because of conflicting media reports and the fact that it’s all lumped together.”

Following a total hysterectomy in 2005, Candler mom Lynn Nicolai, a nursing educator, went on a fairly high dose of estrogen. She visited the doctor several times with increasing incidents of weight gain, bloating, insomnia and depressive symptoms. She left each visit with increased estrogen doses and a prescription for sleeping pills, an anti-depressant or an appetite suppressant.

“After about six months, I was bloated, sleepless and depressed,” Nicolai says. A co-worker advised her to use a bioidentical progesterone cream to overcome estrogen dominance.

“Within two weeks, I felt much better and was losing the bloating,” Nicolai says. She researched hormones and menopause and learned that even without ovaries, other body parts produce estrogen.

Nicolai later experienced brain fog and memory issues. Her new doctor recommended synthetic hormones, which she didn’t want to take. She began using estrogen and testosterone creams, along with progesterone pills, but after three weeks, had gained eight pounds.

Nicolai now takes an oral progesterone capsule. “I just need to be very careful with estrogen because it just didn’t work for me,” she says.

Risks and Alternatives

In 1991, the National Institute of Health’s Women’s Health Initiative conducted a study on HRT. Before the study, the medical community thought hormone replacement therapy didn’t have many risks and would help people stay healthy longer. Study authors looked at just one conjugated estrogen-progestin (a synthetic progesterone) in post-menopausal women, but ended the study in early 2002.

The first phase showed an increased risk of stroke and blood clots, as well as an increased risk of breast cancer, Grana says. The results caused a lot of U.S. women to stop taking HRT. Grana notes that the average age of the women studied was 63; 50 percent were smokers or ex-smokers and 50 percent were overweight.

Other HRT options, including bioidentical estrogen and progesterone, have not been studied, Grana and Garrett point out, so risks, benefits and side effects associated with those treatments are unknown.

Data in the last 10 years shows that HRT should be started at the time of menopause, that it may prevent heart disease and that it should not be started 10-12 years after menopause, according to Grana. Most literature says HRT should be started during the first seven years of menopause. (Read more about the study at www.nhlbi.nih.gov/whi.)

Whether or not you use HRT, some simple changes can make your life and body healthier before, during and after the transition to menopause. Garrett recommends avoiding caffeine and alcohol because they can increase cortisol, and alcohol increases estrogen. She also suggests avoiding processed food because it contributes to weight gain and sugar addiction.

Try yoga and/or other forms of exercise (45 minutes to 1 hour, five days a week, plus strength training two days a week). Garrett also suggests acupuncture, known to help decrease hot flashes.

Grana talks in detail with patients about their medical, surgical and family histories. “I treat every patient on an individual basis to assess if she’s a good candidate, and review every year if she’s still a good candidate,” she says.

If you chose to do HRT, it’s best to start close to the beginning of menopause and to use the lowest dose possible for the shortest amount of time. “The key to HRT is to balance benefit to harm,” Grana says.

Cathy Downs is a freelance writer and mom to two boys. She and her family live in Cary.

 

Edit ModuleShow Tags
Edit ModuleShow Tags

Related Content

Tips to Organize Your Child's Space, Cut Sugar & Picks for Books

From organizing your child's space to heartwarming books and cutting sugar culprits from your family's diet, these tips make it easy.

Products We Like: Leggings, Frozen Twists, Workout Apps, Books & More

From workout to hair styles to food, fashion and books, discover the latest products to help you stay on track.

Body Satisfaction Low for Women Ages 50 and Older

Just 12.2 percent of women ages 50 and older are satisfied with their body size, according to a UNC's Gillings School of Public Health study.
Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

December 2019

Wear your favorite holiday attire and dine with Santa Claus. Enjoy a delicious brunch, stories and crafts, and take pictures with the jolly man from the North Pole. 

Cost: $10/child. Free for ages 2 and younger

Where:
Joyner Park Community Center
701 Harris Rd.
Wake Forest, NC  27587
View map »


Website »

More information

Participants develop their naturalist skills and understanding of local nature. Ages 5-8 with parent. Register online. 

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Girls ages 5-12 take their favorite doll and have a creative time together preparing for the holidays. Register by emailing llpolkhouse2@gmail.com.

Cost: $22/attendee, $20/sister

Where:
Historic Polk House
537 N. Blount St.
Raleigh, NC  27604
View map »


Telephone: 919-676-6368
Website »

More information

See dancers and a guitarist from Flamenco Carolina perform a Spanish style of music and dance.

Cost: $3/person

Where:
Century Center
100 N. Greensboro St.
Carrboro, NC  27510
View map »


Website »

More information

Ebeneezer Scrooge was visited by three spirits, but what about the next Christmas? With heartwarming excitement, discover how the Cratchit family has fared in the year that has passed since old...

Cost: Free

Where:
Wake Forest Renaissance Centre
405 S. Brooks St.
Wake Forest, NC  27587
View map »


Website »

More information

The Durham Medical Orchestra performs with special guest Joseph Alessi, principal trombone, New York Philharmonic.

Cost: Free

Where:
Baldwin Auditorium, Duke University
1336 Campus Dr.
Durham, NC  27705
View map »


Website »

More information

As a Christmas gift to our community and surrounding area, Wake Forest Presbyterian Church delivers the true Christmas story in a stirring virtual “walk” through Bethlehem to the stable...

Cost: Free

Where:
Wake Forest Presbyterian Church
12605 Capital Blvd
Wake Forest, NC  27587
View map »


Sponsor: Wake Forest Presbyterian Church
Telephone: 919-556-7777
Contact Name: Meghan Reynolds
Website »

More information

Fun for the entire family, enjoy this wonderful, witty retelling of a classic fairy-tale. With a score consisting of well-known pop songs, follow Snow White and her Seven Dwarves as they try to...

Cost: $10-$60/person

Where:
Duke Energy Center for the Performing Arts
2 East South Street
Raleigh, NC  27601
View map »


Sponsor: Duke Energy Center for the Performing Arts
Telephone: 919-996-8700
Contact Name: Blake Jones
Website »

More information

The choir presents its 49th performance on Handel's "Messiah."

Cost: Free

Where:
White Plains United Methodist Church
313 S.E. Maynard Rd.
Cary, NC  27513
View map »


Website »

More information

Show More...
Show Less...

The first day of winter is right around the corner! Help us welcome the season by making a snow globe to take home. We will bring the materials if you bring the imagination! For all ages (adult...

Cost: For all ages (adult accompaniment required for all children); FREE. Registration

Where:
Crowder County Park
4709 Ten-Ten Rd
Apex, NC  27529
View map »


Telephone: 919-662-2850

More information

Children will enjoy this wonderful book written by John Denver reminding us not to forget about the wildlife this holiday season. We will make a craft then take a walk to look for our wildlife...

Cost: Free

Where:
Harris Lake County Park
2112 County Park Dr.
New Hill, NC  27562
View map »


Sponsor: Harris Lake County Park
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
Website »

More information

Show More...
Show Less...

Join RTOOT as it performs the music of great Italian composers as well as beloved Christmas classics. Purchase tickets online. 

Cost: $9/adult, $3 ages 12 and younger

Where:
Cary Arts Center
101 Dry Ave.
Cary, NC  27511
View map »


Website »

More information

Show More...
Show Less...

Dan the Animal Man brings some of his animals from his vast collection to entertain all ages. 

Cost: $3/person

Where:
Century Center
100 N. Greensboro St.
Carrboro, NC  27510
View map »


Website »

More information

Help find candy canes hidden in Bond Park before the Grinch turns them green. Ages 6-12. Registration required online. Choose course #127871. 

Cost: $10/child

Where:
Bond Park
801 High House Rd.
Cary, NC
View map »


Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Show More...
Show Less...

Ages 1-5 and caregiver delight in the discoveries of nature. Register online. 

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Get into the holiday spirit by decorating cooking, making a craft and enjoying a holiday children's show.

Cost: Free

Where:
Century Center
100 N. Greensboro St.
Carrboro, NC  27510
View map »


Website »

More information

The Wake Forest Abilities Choir will present an evening of holiday music under the direction of director.

Cost: Free

Where:
Wake Forest Renaissance Centre
405 S. Brooks St.
Wake Forest, NC  27587
View map »


Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Show More...
Show Less...

Celebrate pecans at the State Farmers Market.

Cost: Free

Where:
State Farmers Market
1201 Agriculture St.
Raleigh, NC  27603
View map »


Website »

More information

Join us to learn about how Habitat for Humanity helps build houses, hear a Christmas tale and then build a graham cracker house of your own. Call to, 919-245-2532. Best for ages 4 and up with a...

Cost: free

Where:
Orange County Main Library
137 W Margaret Ln
Hillsborough, NC  27278
View map »


Sponsor: Orange County Public Library
Telephone: 919-245-2539
Contact Name: Libbie Hough
Website »

More information

Is there a man in the moon, and is the moon made of cheese? Sip on some hot cocoa and listen to some of the stories people have told about the moon and find out if there is truth to them. Then...

Cost: For all ages; FREE. Registration is required for everyone, and adult accompanime

Where:
Crowder County Park
4709 Ten-Ten Rd
Apex, NC  27529
View map »


Telephone: 919-662-2850
Website »

More information

Discover family traditions from North Carolina and around the globe. Create art, enjoy free access to Frida Kahlo, Diego Rivera, and Mexican Modernism, and have a special visit with Santa.

Cost: Free

Where:
North Carolina Museum of Art East Building and Museum Plaza
Raleigh, NC


Website »

More information

Bundle up and enjoy an evening around the campfire learning about creatures of the night and listen to Native American tales about some of our favorite nocturnal animals. Roast marshmallows and go...

Cost: Free

Where:
Harris Lake County Park
2112 County Park Dr.
New Hill, NC  27562
View map »


Sponsor: Harris Lake County Park
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
Website »

More information

Kids ages 5-12 enjoy indoor activities while parents enjoy a night out. Register online. 

Cost: $30/resident, $45/nonresident

Where:
Halle Cultural Arts Center
237 N. Salem St.
Apex, NC  27502
View map »


Website »

More information

Wear white clothing and play games, tumble and dance. Enjoy pizza, drinks and more. Ages 5-10. Registration required online. Choose course #127487.

Cost: $18/child; $28 for two children per family

Where:
Middle Creek Community Center
125 Middle Creek Ave.
Apex, NC  27539
View map »


Website »

More information

Friday, December 13, 6:00pm, at both the Millbrook and Wake Forest Campuses. Put on your Christmas jammies, grab a blanket and come out for a  festive night to watch the classic animated...

Cost: Free

Where:
Crossroads Fellowship
2721 E Millbrook Road
Raleigh, NC  27604
View map »


Sponsor: Crossroads Fellowship
Telephone: 919-981-0222
Contact Name: Lorraine Entwisle
Website »

More information

Have some fun and make something great at the Clay studio (and parents can sneak away and grab a bite or do some shopping at Northgate Mall). Each kid will complete and paint a piece of pottery...

Cost: $18 per child per workshop

Where:
1058 West Club Blvd
Durham, NC  27701
View map »


Telephone: 919-560-2726
Contact Name: Lauren Tannenbaum
Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Sing along with the band as they perform holiday favorites of Christmas, Hanukkah, the winter solstice and more. 

Cost: Free

Where:
Cary Senior Center
120 Maury O'Dell Place
, NC  27513
View map »


Website »

More information

Show More...
Show Less...

Celebrate the love and joy that this season brings by creating art inspired by a Christmas tree. Register online. Choose course #126761.

Cost: $32/resident, $42/nonresident

Where:
Cary Arts Center
101 Dry Ave.
Cary, NC  27511
View map »


Website »

More information

Give rugby a try. Take part in tag rugby pick-up games every Saturday morning at Baileywick Road Park, near the Second Shelter.  No experience necessary. All ages. 

Cost: Free

Where:
Baileywick Road Park
9501 Baileywick Rd
Second Shelter Field
Raleigh, NC  27615
View map »


Sponsor: Raleigh Redhawks Rugby
Contact Name: denise travis
Website »

More information

Our Reindeer Romp is open to the entire community and our Girls on the Run families. So join us! Celebrate as nearly 1,000 girls reach their end-of-season goals – the finish line is only the...

Cost: $30 - $35

Where:
Koka Booth Amphitheater
8003 Regency Pkwy
Cary, NC  27518
View map »


Sponsor: Girls on the Run of the Triangle
Telephone: 919-401-6307
Contact Name: Jamie Botta
Website »

More information

Ages 5-12 make a picture frame for the holidays. Snack provided. Register online. 

Cost: $30/resident, $45/nonresident

Where:
Halle Cultural Arts Center
237 N. Salem St.
Apex, NC  27502
View map »


Website »

More information

Ages 1-5 and caregiver delight in the discoveries of nature. Register online. 

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Travel with us to Puerto Rico with books, games and arts and crafts!  Join the staff of ISLA (Immersion for Spanish Language Acquisition) for a fun filled hour! Best for ages 3 and up with a...

Cost: Free Gratis

Where:
Orange County Main Library
137 W Margaret Ln
Hillsborough, NC  27278
View map »


Sponsor: Orange County Public Library
Telephone: 919-245-2539
Contact Name: Libbie Hough
Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

One ticket admits the entire family to decorate a special gingerbread house. Supplies provided. Workshops available at 2 p.m. and 4:30 p.m. Allergy-free workshop available at 11 a.m....

Cost: $40

Where:
Family Preschool
4907 Garrett Rd
Durham, NC  27707
View map »


Sponsor: Family Preschool
Telephone: 919-402-1500
Contact Name: Sue Henson
Website »

More information

Family Wildlife Series: Holiday Habitat Helpers Saturday, December 14, 2-3 Attract winter wildlife to your backyard by providing or improving their habitat.  Create simple outdoor decorations...

Cost: Free

Where:
Blue Jay Point County Park
3200 Pleasant Union Church Rd
Raleigh, NC  27614
View map »


Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Embark on a wild ride with favorite Disney characters Mickey, Minnie, Goofy and many others in this fun-filled getaway featuring unexpected hijinks and character interaction. Purchase tickets...

Cost: $15 and up

Where:
PNC Arena
1400 Edwards Mill Rd.
Raleigh, NC  27607
View map »


Website »

More information

Join us as we watch for meteors during the Gemenids Meteor Shower. Local astronomers will help us observe these shooting stars and other phenomena in the night sky. As a bonus we may see or hear...

Cost: Free

Where:
American Tobacco Trail
1309 New Hill-Olive Chapel Rd.
Apex, NC  27502
View map »


Sponsor: Harris Lake County Park and the American Tobacco Trail
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
Website »

More information

Favorite Christmas songs are presented in authentic Nashville country style with dazzling guitars and fiddles along with soaring harmonies. Purchase tickets online. 

Cost: $25/person

Where:
Wake Forest Renaissance Centre
405 S. Brooks St.
Wake Forest, NC  27587
View map »


Website »

More information

See the choir perform beloved Christmas songs with guest vocal group AVANTE. Purchase tickets online. 

Cost: See website for fees

Where:
Cary Arts Center
101 Dry Ave.
Cary, NC  27511
View map »


Website »

More information

Show More...
Show Less...
Edit Module Edit ModuleShow Tags
Edit Module

Newsletter Sign-Up

Stay connected to what's going on for families in the Triangle by signing up for our FREE e-newsletters!

Subscribe

Edit ModuleShow Tags

Directories

Edit ModuleShow Tags Edit ModuleShow Tags

Annual Guides

Education Guide

The 2019-20 Education Guide offers 718 education resources in the Triangle, including area preschools, private schools, public school systems, charter schools, boarding schools and academic resources.

The Triangle Go-To Guide

Our Triangle Go-To Guide connects you to family fun resources across the Triangle. In our 2019-20 issue, explore 1,028 resources for family fun.