How to avoid the side effects of hormone replacement therapy.

Dear MHI reader,

Hormone replacement therapy is often recommended as an effective solution for menopausal symptoms such as hot flashes or sleep disorders. However, many women report unwanted side effects and challenges during treatment.

In this newsletter, we’ll show you step by step how to better understand the risks and side effects of hormone replacement therapy and make an informed decision that will improve your well-being during menopause.

Why should you care about the side effects of hormone replacement therapy?

Menopause often brings challenges such as hot flashes, sleep disturbances, or mood swings. Hormone replacement therapy may be recommended as a solution, but how do you know if it’s right for you?

By educating yourself, you can:

• Effectively relieve your symptoms.
• Better assess risks and avoid long-term complications.
• Feel confident because you’re making a conscious decision.

Unfortunately… many women struggle with hormone replacement therapy

Despite its benefits, some women fail to successfully use hormone replacement therapy. This is often due to a lack of important information or certain obstacles standing in their way. But don’t worry – we’ll show you how to overcome these hurdles.

Main reason: Lack of knowledge about side effects and risks

Side effects can generally occur with all medications, including the hormone preparations used in hormone replacement therapy. Many women start hormone replacement therapy without knowing exactly what side effects may occur. These include:

• Hot flashes and sweating: Although hormone replacement therapy is often used to relieve these symptoms, in some cases they may persist or even become more severe.
• Dry mucous membranes: Dryness may occur, particularly in the urogenital area, which can lead to discomfort during intercourse.
• Mood swings and sleep disorders: These psychological symptoms are common and can significantly impair quality of life.
• Menstrual bleeding: This may also occur.
• Tension in the breasts: this can occur with oestrogen-progestogen preparations.

The side effects that can occur with long-term hormone replacement therapy are more serious. Depending on the preparation, there is an increased risk of various illnesses:

• Increased risk of certain types of cancer: in particular, when using oestrogen-progestogen preparations, there is an increased risk of breast cancer with longer periods of use.
• Cardiovascular risks: Therapy can increase the risk of strokes and heart attacks, especially with long-term use.
• Thromboembolism: There is an increased risk of blood clots, which can lead to serious complications such as pulmonary embolism.

Because the side effects can be severe, hormone replacement therapy during menopause should be used when the benefits clearly outweigh the risks. It should be as short and low-dose as possible.

Other reasons why hormone replacement therapy can be difficult:

• Fear of health risks: Perhaps you have heard about an increased risk of breast cancer or cardiovascular risks and are unsure.
• Lack of personalised advice: Not every therapy is suitable for every woman, but this is often not sufficiently explained.
• Lack of knowledge about alternatives: Many women are unaware that there are also herbal or non-hormonal options.
• Impatience: It takes time for the effects of hormone replacement therapy to be felt, and this can be frustrating.
• Misconceptions: There are many myths about hormone replacement therapy that are not always true.

And what happens when you stop taking the hormones?

If hormone replacement therapy is stopped, the symptoms may return. At that point, it may be a good idea to reconsider whether you want to continue the therapy. For other women, typical menopausal symptoms have subsided after hormone therapy.

There is hope: you can overcome all these challenges!

The good news is that you can take control of your health by taking the right steps. We will show you how to do it.

Step 1: Get thorough information

Why is this important? If you know the possible side effects and risks, you can make better decisions from the outset.

What can you do?

• Read reputable sources, such as articles on health portals or studies.
• Talk openly with your doctor. Ask any questions you might have, for example about dosage or treatment alternatives.

Example: Anna, 52, had severe hot flashes and was sceptical about hormone replacement therapy. After a detailed consultation, she opted for a low-dose therapy – and was able to successfully alleviate her symptoms.

Step 2: Get your individual health assessed

Where many go wrong: Often, a standard therapy is chosen without addressing personal risk factors such as family medical history or lifestyle.

How do you do it better?

• Request a comprehensive health assessment, for example blood tests to determine your hormone levels.
• Talk specifically about alternatives, such as local or low-dose hormone supplements, that carry fewer risks.

Example: Sabine had an increased risk of breast cancer and, after consulting a doctor, decided on a non-hormonal treatment. This helped her to get her symptoms under control without having to worry about long-term side effects.

Step 3: Take a holistic approach

Why it’s important: Hormone replacement therapy works best when combined with a healthy lifestyle.

How can you implement this?

• Eat a balanced diet with plenty of fruit, vegetables and healthy fats to support your body.
• Find a form of exercise that you enjoy, whether it’s yoga, swimming or regular walks.
• If necessary, supplement the therapy with alternative methods such as acupuncture or herbal supplements – but make sure you choose reputable providers.

By taking these steps, you can not only alleviate your symptoms but also improve your overall quality of life.

Knowledge gives you back control

Hormone replacement therapy can be a great support during the menopause – if it is used consciously and individually. With the right information and a holistic strategy, you can reap the benefits and minimise the possible risks.

You want to read more about hormone replacement therapy. We have put together a few blog posts and newsletters for you here:

Hormone replacement therapy (HRT) – What do I need to know?

#062: What is bioidentical hormone replacement therapy?

#046: Is there an increased risk of cancer with hormone replacement therapy?

#009: Is hormone replacement therapy right for me?

#076: Managing the menopause: How to choose between hormonal and alternative treatments

Take the first step and take control of your health. You are not alone – we are here to support you on your journey!

This is our last newsletter in 2024. We wish you a Merry Christmas and a relaxing time. We look forward to welcoming you back in 2025.