Understanding Menopause Hormone Therapy

May 7, 2025

Lecture Notes: Menopause Hormone Therapy by Dr. Mary Claire Haver

Introduction

  • Speaker: Dr. Mary Claire Haver
    • Board-certified obstetrician gynecologist
    • Menopause expert, certified in culinary medicine
    • Creator of the Galveston Diet
  • Topic: Menopause Hormone Therapy (HRT)
  • Objective: Overview of treatment options for hormone therapy and how to discuss them with physicians.

What is Hormone Replacement Therapy (HRT)?

  • Definition: Provides hormones during estrogen deficiency in perimenopause and menopause.
  • Main Hormone: Estrogen
    • Three types: Estradiol, Estriol, Estrone
    • Focus on Estradiol for HRT

Types of Estrogen for HRT

  • Synthetic Estrogens: Often found in birth control, synthetic versions like Ethinyl estradiol.
  • Body Identical (Estradiol): Considered more natural.
  • Conjugated Equine Estrogens (Premarin):
    • Expensive and considered unethical due to production methods.

Methods of Administration

  • Oral Pills: Common but can increase clotting factors.
  • Transdermal Options: Patches, gels, creams.
  • Vaginal Rings & Pellets: Alternative forms of administration.

Progesterone Use

  • Necessary if Uterus is Present: To protect the uterine lining.
    • Forms: Progesterone, synthetic progestins, or progesterone IUD (Mirena).
  • If No Uterus (e.g., post-hysterectomy): Estrogen alone may suffice.

Compounded Bioidenticals

  • Pellets: Combination of estradiol with estriol or estrone.
    • Concerns about accuracy and FDA regulation.

Insurance and Cost

  • Generic Versions: Available for cost reduction.
  • Insurance Coverage: Generally covers pharmacy-prescribed forms but not compounded forms.

Health Benefits and Risks

  • Benefits: Reduces risk of heart disease, osteoporosis, Alzheimer's, colon cancer, and more.
  • Risks: Slight increase in blood clots with oral forms.
  • Recent Studies: 2022 North American Menopause Society report supports HRT benefits over risks for women under 60 without contraindications.

Questions and Common Concerns

  • Common Concerns: Cancer risk, weight gain, and safety.
  • Misconceptions: Body identical vs. synthetic efficacy and safety.
  • Doctor Recommendations: Find menopause-friendly doctors.

Final Thoughts

  • Importance of Discussion: Arm yourself with information to advocate for hormone replacement therapy.
  • Future Resources: Online webinars and detailed educational content.

Note: This lecture summary contains key points and insights provided by Dr. Mary Claire Haver on menopause hormone therapy, intended for educational purposes. Always consult with a healthcare provider for personal medical advice.

Full transcript