Scared of HRT? Here’s How to Weigh Your Options with Confidence

At Navis, we often meet women who’ve gone so far as to get their hormonal replacement therapy prescription written up, only to pause, linger, and reconsider. Some find themselves endlessly researching, speaking to doctor after doctor, wanting to feel 100% sure before moving forward.

It’s normal to feel hesitant, especially with so much information (and sometimes misinformation) out there. You might worry about side effects, or maybe just the word “hormone” feels intimidating.

Whatever your concerns, they’re valid. And you don’t have to make this decision alone or in a rush. Let’s look at some of the big concerns surrounding HRT, and how science, research, and real stories can help you feel confident about what’s right for you.

Concerned About Breast Cancer?

When the topic of HRT comes up, it’s almost guaranteed someone will mention breast cancer. It’s a natural concern, especially when we’re so conscious of protecting our health. So, what’s the truth? Are hormones risky?

Research shows that HRT is more complex than simply “causing cancer” or “not causing cancer.”

A large study in Norway of over a million women found that breast cancer risk associated with HRT varies by factors such as the type of HRT, individual drugs, detection methods, and even BMI. For instance, vaginal estradiol—a form of estrogen—was not linked to an increased breast cancer risk. In other words, HRT hasn’t been proven to cause breast cancer; instead, some types show a potential link that’s still being studied.

If you’re concerned, know that talking with a knowledgeable doctor is key. They can walk you through your personal risk factors—like family history, lifestyle, and medical background—to help you make an informed decision that’s right for your body and health.

Nervous About Heart Risks?

Some worry that HRT could increase their chances of a heart attack or other heart issues. But research reveals that this concern depends greatly on individual health factors.

As Professor Bryant Stamford, an expert in kinesiology, explains, each woman’s heart health is unique. He suggests that doctors evaluate HRT candidates based on:

When menopause started, and how long after menopause HRT might begin.
Medical and family history of heart disease or breast cancer.
Specific heart risk factors that go beyond age alone.
The exact HRT type that’s suitable based on symptoms and health profile.

If heart problems run in your family, or you have a history of high blood pressure, HRT may still be a safe option with adjustments to dosage or type. With your doctor’s guidance, HRT can be tailored in a way that either reduces heart risks or offers alternatives if the risks feel too high.

Worried About Dementia?

he fear of dementia, especially Alzheimer’s, understandably looms large for some women considering HRT.

Studies are still uncovering the ways hormones may impact cognitive health, but so far, the findings show that HRT might actually have protective benefits against Alzheimer’s, especially if started earlier in menopause.

Some studies suggest that estradiol—a form of estrogen in HRT—may help reduce the risk of Alzheimer’s in younger women or those who start HRT near the beginning of menopause. However, this potential benefit may lessen with age.

But while some studies show a link between long-term HRT use and a slight increase in dementia risk, others have found no significant connection. Researchers emphasize that more studies are needed, and so far, there’s no clear evidence that HRT directly leads to dementia.

If you’re concerned about memory or cognitive health, your doctor can help weigh these risks based on your age and family history. And remember, the slight increase in risk (if any) is small, so it’s okay to approach this with curiosity rather than fear.

Will HRT Cause Weight Gain?

This is another big one: the worry that HRT will lead to weight gain. But here’s the reassuring truth—HRT doesn’t cause weight gain on its own.

Weight gain around menopause is common for many women, whether or not they take HRT. It’s usually a natural part of aging, influenced by slowing metabolism and lifestyle changes rather than hormones alone.

Talk to Real Women Who’ve Been There

Sometimes, hearing from others who’ve walked this path can be just as comforting as research data. Many women have shared that HRT has brought them relief from intense hot flashes, night sweats, and other menopause symptoms. Others report less anxiety and moodiness, or simply feeling more like themselves again. But of course, not everyone is thrilled with HRT. Some women don’t enjoy taking medication long-term, while others may be perfectly fine without it.

Know Your Options: Different Types of HRT Explained

Still need more advice?

Here’s a quick guide to the HRT care you will receive:

Types of HRT

Cyclic HRT: For women who still get their periods, this type is taken in cycles to mimic natural hormonal rhythms. It’s often recommended for those in the early stages of menopause (perimenopause) who need some extra support.
Combined Therapy: This is a mix of estrogen and progestin taken daily, usually for women who haven’t had a hysterectomy. This combination helps protect against uterine cancer.
Estrogen-Only HRT: For women who’ve had their uterus removed, estrogen-only HRT is a popular choice as it doesn’t carry the same uterine risks.

HRT Delivery Methods

HRT comes in several forms, and choosing one that fits your lifestyle can make the experience much smoother:

Oral HRT: Tablets taken daily, providing a traditional but effective form of hormone replacement.
Patch HRT: Hormone patches that stick to your skin, releasing a steady dose and reducing digestive side effects.
Vaginal HRT: Creams or inserts that target vaginal dryness and discomfort without affecting the whole body. Ideal for women who need localized relief.

Whether you want to keep things simple with a pill or prefer a patch that lets you skip the daily dose, your doctor can help you pick the best delivery method.

Trust Your Own Journey

Deciding whether to start HRT is a personal journey, and there’s no right or wrong answer. It’s all about finding what works best for you and your body. Take the time you need to learn, ask questions, and consider your options with your doctor. You don’t need to feel pressured into a choice, and it’s okay if your decision changes over time.

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