Before starting any treatment for menopause (natural or not), it can be helpful to undergo a hormone test to find out which hormone imbalances you may have, as they differ with each woman and at different stages of menopause. For women with mild-to-moderate symptoms, good menopause nutrition, exercise and nutritional supplements are usually enough. But there are times when it is important to have the complete picture so we can create the right action plan to resolve particular conditions. 

I generally use a DUTCH Dried Urine Hormone Test by Precision Analytical Inc. for my holistic menopause treatment. This advanced form of hormone testing has been developed to improve on available hormone testing options (saliva, serum or 24-Hr urine testing). DUTCH offers:

• The most extensive profile of sex & adrenal hormones along with their metabolites
• The daily (diurnal) pattern of free cortisol – the stress hormone
• Melatonin – the sleep hormone
• Oxidative DNA damage (8-OHdG)
• 6 organic acids – check dopamine, norepinephrine, epinephrine, serotonin, B12, B6 and glutathione status
• Detoxification pathways of oestrogen metabolites – lower your risk of breast cancer

This unique combination of clinical information is not available by any other method. A DUTCH test can be used in conjunction with HRT; and its unique methods are used for improving monitoring of oral progesterone and vaginal hormones.                

DUTCH website for patient information: https://dutchtest.com/patients/ 

DUTCH Complete Information sheet: https://dutchtest.com/wp-content/uploads/2015/11/DUTCH-White-Paper-1.pdf 

In addition to DUTCH, I am also able to provide saliva, blood serum, or 24-Hr urine testing as required. 

Controversial research from 2002 found that women on HRT had an increased risk of breast cancer and cardiovascular disease. Today, medical recommendations say the treatment is safe for younger women for short periods. However, many patients discontinue HRT within the first 8 months due to side effects such as spotting, bleeding and breast tenderness. Many more women are reluctant to start HRT at all and are looking for a more holistic treatment for menopause. 

So what speaks against HRT? 

• HRT uses synthetic and/or animal derived hormones. Due to menopause, our bodies no longer expect to receive these hormones. This type of hormone replacement can have serious side-effects such as blood clotting [1] and breast cancer [2].
  The increased breast cancer risk can be explained by the liver’s role in sex hormone regulation, primarily oestrogen. However, whenever there are excess hormones (whether produced by the body or received through hormone therapy), the liver can’t process the load as quickly/efficiently, causing a hormone imbalance. Researchers found that oestrogens break down into oestrogen metabolites with varying levels of oestrogenic activity. The stronger this activity, the greater the risk of developing oestrogen-related cancer [3]. 

• Synthetic oestrogen replacement therapy can deplete key nutrients like magnesium and vitamin B6.  
• Synthetic progestins can deplete many nutrients including B vitamins, tyrosine, CoQ10, vitamin E and folic acid. 
• Taking synthetic HRT by mouth can also increase imbalances in your natural gut flora, causing increases in Candida (yeast) populations [4]. 

Before you ever consider an extreme treatment such as HRT, I would strongly recommend you first implement appropriate menopause nutrition and lifestyle changes, while supporting your body with specific nutritional supplementation. When working with me to promote the balance of your own hormones, you may well find it is completely unnecessary to take any kind of invasive hormonal therapy! 

“Treating hormone imbalances requires a whole-body approach; the best approaches are often preventive and involve diet, exercise and other lifestyle-based strategies” – Dr Mercola [5]

Natural bio-identical hormones can offer relief from menopausal symptoms, but they should not be your first go-to option. Just like HRT, they don’t offer a holistic approach and neglect menopause nutrition, exercise and lifestyle. 

As discussed above, the biggest concern is your liver’s ability to cope with the influx of sex hormones. First ask yourself: ‘Am I eating and living in ways that support optimal liver function?’ Hormonal overload (whether natural or synthetic) causes hormone imbalance, and oestrogens breaking down into specific oestrogen metabolites carry a risk of developing oestrogen-related cancer [2].

What’s more, it is impossible to achieve the best balance without knowing your true hormonal status through appropriate testing. BHRT may not work in some women because of their health habits or the fact that many of their hormones are  imbalanced. If we, for example, address only your sex hormones we won’t be successful if you are under chronic stress. In this case, your body will be making excess cortisol which can disrupt your metabolism. This, in turn, leads to further imbalances in sex hormones and other hormones such as thyroid.  

As you can see, taking bio-identical hormone replacement without implementing menopause nutrition protocols and lifestyle changes can result in continuation of symptoms and even cancer. 

Choosing a holistic treatment for menopause may render it unnecessary to look any further into BHRT. Or at the very least, provide you with a great stepping stone to using BHRT in a way that will support your health and wellbeing rather than creating more problems.