20 mins read

Menopause And HRT: How To Know If It’s Time To Reevaluate


medically reviewed by Dr Godmi Tresa

Dr. Bhavya

Updated on October 24, 2023

The span of my hips,   

The stride of my step,   

The curl of my lips.   

I’m a woman


Phenomenal woman,   

That’s me.

Poets and philosophers like William Shakespeare to Rupi Kaur have long celebrated the beauty of women, from the radiance of their skin to the grace of their movements. 

And throughout their lives, women have invested significant efforts in maintaining their beauty, even as they age.

As women approach menopause, the transition can be both exciting and daunting. 

The process marks a significant shift in a woman’s life, and while some embrace it as a new chapter filled with growth and discovery, others may feel overwhelmed by the changes happening within their bodies.

Menopause can present new challenges for women but is also a chance to realign with their values and prioritise their well-being. For many women, Hormone Replacement Therapy (HRT) is a standard treatment for managing menopause symptoms. 

But how can you point out if it’s working for you? Let’s explore the topic further.

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What is HRT?

Hormone replacement therapy (HRT) is a standard treatment used to alleviate the symptoms of menopause, like hot flashes and vaginal dryness, by supplementing the body’s declining estrogen levels.
It is also called Menopausal hormone therapy (MHT)

HRT has been used since the late 1990s, with studies showing it is efficient in preventing long-term estrogen deficiency.
However, its use declined after the Women’s Health Initiative findings were released in 2002, highlighting that HRT’s risks outweighed its potential benefits. 
Despite this, HRT remains a viable option for many women to manage the symptoms of menopause, with tailored doses and timing for each patient. 

Is HRT for everyone?

Although some women believe that HRT can help manage menopause symptoms and improve mental health, it’s essential to recognise that HRT may not be suitable for everyone and can have unknown risks and side effects. 

Thus, exercising caution and consulting with a medical professional is crucial before taking HRT.

Some of the cases where one should not use HRT are:

  • Breast cancer, ovarian cancer, or uterine cancer
  • Blood clots
  • High blood pressure – Your blood pressure must be controlled before starting HRT.
  • Liver disease
  • Pregnancy - also, it’s still possible to get pregnant while taking HRT. So, you should use contraception method until two years after your last period. Especially, if you’re under 50 or for one year after the age of 50 

The type and method of HRT intake in each individual differ. This difference is because each one of you goes through menopause differently. Your lifestyle, diet changes, work and sleep habits, etc., can influence this difference. 

Fact Check: The most common opinion from our doctors is that when women live with more stress, stay up late at night, and not getting enough sleep, they have more symptoms. Sometimes, HRT can also stop working.

What are the Limitations of HRT?

For decades, HRT has been a go-to recommendation for menopausal women across the US.

However, recent research indicates that HRT is not a great preventative measure as it increases the risk of heart attacks instead of preventing them.

As a result, more doctors are recognising the limitations of HRT and only prescribing it to women who experience severe menopausal symptoms that disrupt their daily lives, such as hot flashes that cause sleep disturbance. It’s crucial to consult a medical professional and weigh the risks and benefits before considering HRT as a treatment option for menopausal symptoms.

How Does HRT Make You Feel?

HRT can be an effective treatment for menopausal symptoms, but knowing how it makes you feel is essential. Here are some things to keep in mind:

  • Track your symptoms: Record any changes in your mood, energy levels, and other symptoms. Doing so can help you and your doctor adjust your treatment if necessary.
  • List your medications: Tell your doctor about all your medications, including over-the-counter supplements. Some medicines can interact with HRT and affect how you feel.

While HRT can help relieve menopausal symptoms, it can also cause side effects. These may include:

  • Indigestion
  • Headaches
  • Blurred vision
  • Fatigue
  • Spotting and cramping
  • Mood swings
  • Weight gain
  • Redness at the site of injection or application

It’s crucial to give HRT time to work. Depending on the dose and type of therapy, it can take up to three weeks to see some effects.

Initially, you may feel worse or experience side effects. But, if these side effects persist or become severe, you should speak with your doctor.

What Are The Signs Your HRT Is Not Working For You?

Signs HRT Is Not Working For You

If you are on HRT and still experiencing the same old menopausal symptoms, it could be a sign that the treatment isn’t working for you.

It’s crucial to watch out for the symptoms that your hormones are out of balance.

It might be time to reevaluate your HRT regimen if you are dealing with night sweats, mood swings, and sleepless nights again.

Feeling unsettled and not sure why?

Check these key factors to determine if your HRT isn’t working:

  • Are you taking the correct dose of HRT?
  • Is the type of HRT you use the best fit for your body?
  • Are you following the accurate administration method for your HRT?
  • Have you been on HRT for at least three months?
  • Could your symptoms be related to menopause or another underlying condition?

If you’ve considered all of these factors and still find that HRT isn’t working for you, it may be time to check your estrogen levels and adjust your treatment.

It’s worth noting that some women find HRT less effective over time, so it’s essential to stay in tune with your body and be aware of any changes. 
Here are some common signs that HRT isn’t working for you:

  • You feel fatigued all the time, despite getting enough rest
  • You’re having trouble sleeping
  • You’re struggling to maintain a healthy weight
  • Your libido is low
  • You’re still experiencing hot flashes and night sweats

By paying attention to your body and communicating any concerns with your healthcare provider, you can work together to find the best treatment plan.

Are You Considering Discontinuing HRT?

It’s important to remember that abruptly discontinuing hormones may not be the best action.

According to official recommendations, hormone replacement therapy is typically prescribed for about a year before it gets reassessed.
Ideally, the patient is weaned off the therapy, allowing the body to adjust more quickly to the reduced estrogen levels.

It’s essential to remember that the risk of breast cancer and other symptoms may increase after a year of HRT, so it’s crucial to work with a medical professional to create a plan for discontinuing the treatment.

HRT is Not Your Cup of Tea?

HRT natural alternative.png

If you feel that HRT is not for you, why not explore the world of holistic medicine?

Ayurvedic scholars describe the retirement of menstruation between the ages of 45-55 as a natural process.

The retirement of menstruation is seen as a transition, with changes in bio energies that can cause depletion of energy reserves and loss of regular organ functioning.

Ayurvedic rejuvenation therapy, known as “Rasayana therapy,” can help restore the loss.

Additionally, specific dietary guidelines, lifestyle modifications, herbal supplements, detoxification, and yoga can all be beneficial. 
Ayurveda and yoga approach each individual from a specific perspective, allowing treatments tailored to your symptoms, body characteristics, and composition.

By exploring holistic medicine, you may find an effective and natural way to manage the changes that come with menopause.

Why Do Some Women Breeze Through Menopause While Others Struggle?

Researchers now take a multi-dimensional approach to understanding the human body. 

An alternative approach to menopause incorporates the concepts of:

  • Nourishment
  • Contentment
  • Balance

Holistic methods easily heal the body and empower women to live with more joy and fulfilment during menopause.

At Nirva, our consultants have observed that psychological factors significantly affect menopausal symptoms. 

Stress and a lack of routine can exacerbate symptoms, and lifestyles with late nights and little sleep can cause more symptoms. On the other hand, adopting a simpler lifestyle with regular meal times and earlier bedtimes helps keep the body in tune with its natural rhythms.

Have you heard of the famous term ‘IKIGAI’?

In Japanese culture, it means living a life with purpose and meaning. Japanese women have the world’s longest life expectancy, averaging 82 years, and their lifestyle offers insights into why.

None of them smoke, and they consume low amounts of alcohol and coffee. Their diet is low in fat and rich in soybeans and vegetables, which are sources of natural estrogens. They also exercise and use herbal medicines and teas with high phytoestrogen content.

Research by Lock and Kaufert concluded that menopause should not be viewed as the start of chronic problems such as heart disease and osteoporosis.

The medical approach to menopause should be reconsidered, and alternative options should be considered rather than prescribing HRT to all women aged 50 and above.

What is it if not HRT?

Ayurveda can be your answer!
When we start to think of menopause as a natural transition instead of a disease, we can approach it holistically. 
Menopause symptoms vary from woman to woman, and so can the relief methods.

Ayurveda, an ancient holistic approach, identifies three types of body constitutions and related symptoms:

Typical vata symptoms

  • Pain in the abdomen
  • Insomnia 
  • Nervousness/anxiety/panic
  • Mood swings
  • Vaginal/bowel dryness
  • Aching joints
  • Increased sensitivity to the cold

Typical pitta symptoms

  • Night sweats and hot flashes
  • Irritability
  • Anger/hot-tempered
  • Heavy bleeding
  • Acne
  • Urinary Tract Infections

Typical Kapha symptoms

  • Tiredness/lethargyWeight increase
  • Sluggishness
  • Fluid retention
  • Depression
  • Yeast infections

By identifying body symptoms and constitution, an Ayurveda consultant can address menopause changes holistically. If a woman’s doshas are out of balance, she may have more symptoms during menopause. Improving the diet and sleep routine and integrating exercise into the daily routine is essential. Rejuvenation of the body through yoga and Ayurveda by a deeper cleansing of the system over months is also beneficial.

Ayurvedic remedies

Ayurveda remedies to manage menopausal symptoms

Are you looking for natural remedies to manage menopausal symptoms? Ayurvedic practices might be the solution you need. 
Here are some tips to help you beat the dryness and discomfort associated with menopause:

Eat Vata balancing diets:

Balance your Vata bioenergy of movement by eating warm, well-cooked foods with digestive aids such as cumin, fennel, coriander, saffron, and turmeric.

Check and support your Agni (Digestive fire):

Keep your digestive fire intact by drinking a decoction of cumin, coriander and fennel seeds throughout the day.

Bathe yourself in the moonlight:

Moon bathing during summer nights can reduce stress and increase inner strength.

Increase moisture or rejuvenation (Rasayana):

Combat dryness by increasing the body’s moisture levels

  • Self-massage:

Massaging yourself or oleation can reduce menopausal symptoms and improve the health of your joints.

  • Stay hydrated:

Stay hydrated by eating vegetables with high water content, like bottled gourds, melons, cucumbers, zucchini, and drinking water regularly.

  • Apply oils:

Regularly applying oils to your head and foot can improve sleep quality and reduce stress.

  • Pure cow ghee:

Daily, one teaspoon of pure cow ghee in the early morning on an empty stomach can help reset hormones and detox your body.

Incorporating these Ayurvedic remedies into your lifestyle can help you manage menopausal symptoms and promote overall wellness.

Reduce Your Menopausal Symptoms Without HRT

Here are some helpful tips from Ayurveda and Yoga.

Cooling Hot Flashes

Feeling hot and bothered? Try these cooling methods:

  • Practise a cooling pranayama (breathing exercise).
  • Adjust your diet to include cooling foods such as cucumbers, watermelon and coconut water.
  • Drink pomegranate juice and fresh lime with peppermint for a refreshing drink.
  • Maintain a healthy weight to help regulate your body temperature.
  • Meditate to reduce stress and promote relaxation.

Improving Sleep

Having trouble sleeping? Try these methods:

  • Drink warm milk before bedtime to promote relaxation.
  • Meditate before sleep to clear your mind.
  • Set regular bed and wake-up times to regulate your body’s sleep-wake cycle.
  • Aim for 7-8 hours of sleep per night.
  • Avoid napping during the day to ensure a good night’s sleep.

Countering Vaginal Dryness

Feeling dry down there? Try these methods:

  • Increase lubrication using ghee and sesame oil.
  • Stay hydrated! How? By drinking plenty of water throughout the day.

Caring for the Heart

Keep your heart healthy with these tips:

  • Practice mental relaxation techniques, such as meditation and deep breathing exercises.
  • Exercise regularly to maintain a healthy weight and improve heart health.

Maintain Bone Health

Keep your bones healthy and strong with these tips:

  • Practice weight-bearing exercises and yoga.
  • Eat calcium-rich foods such as dairy products, leafy green vegetables, and nuts.
  • Get a daily dose of sunshine to boost your body’s vitamin D production.

Yoga Poses During Menopause

Looking to incorporate yoga into your routine? Try these poses:

  • Twisted Pose
  • Thunderbolt Pose
  • Cat-Cow Pose
  • Downward Facing Dog Pose

Don’t worry if you’re not flexible - support yoga with a chair, pillow, or other props to get started.

So why not give these natural remedies a try and see if they work for you? 
Remember, menopause is a natural transition, and there are plenty of natural ways to manage its symptoms without resorting to HRT.

Embrace menopause with nature!

In the end, it is essential to strive for a balanced lifestyle through a well-planned diet, exercise, and timely sleep.

Health is a culmination of every aspect of a person’s life. Ayurveda, meaning “knowledge of life” or “lifespan,” provides the understanding and knowledge to adjust every part of our lives to promote excellent health, longevity, and spiritual development.

It is crucial to examine how you have been living your life, creating a disturbance in your inner intelligence, which is not allowing your body to adjust to the hormonal changes.

During this time, you must reflect on your lifestyle and habits to uncover the root cause of your symptoms.

As Margaret Mead once said, “There is no more creative force in the world than a menopausal woman with zest.” So, grow into an ageless woman and embrace menopause with the power of nature!

Grow into an ageless woman!

Need expert advice on natural HRT Alternative? Book a free one-to-one assessment call with Nirva Health Coach

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