Hormone replacement therapy is often associated with numerous health benefits as well as risks, but there are plenty of misconceptions and false information circulating about the topic. It is time to debunk some of the biggest myths and reveal the truth.

False: “only hormones help”
For thousands of years, women handled menopause as it is: a natural phase of life, and numerous other remedies were found to alleviate milder symptoms. Herbal supplements may help in some cases, as may a healthy lifestyle, meditation, or yoga. The need to use hormone replacement therapy depends on the severity of the symptoms and the amount of suffering. In general, the stronger the symptoms and the pressure of suffering, the sooner you should consider consulting a doctor about HRT.

False: “HRT pushes you into a vicious circle”
That is, your body becomes dependent on hormone supplements. Many women are afraid of becoming addicted to hormones and stop taking their medication, causing hormonal issues. Therapies have dosage and duration, you should never discontinue therapy on your own initiative! What you can do is to try and not take it once in a while, to see if you are experiencing any issues, then taper down the dosage over time until you get by without. Always consult with your doctor first.

False: “HRT increases the risk of breast cancer”
The correct statement would be that the risk of breast cancer is affected by HRT. The American Cancer Society says estrogen-only HRT is not linked to a higher risk of breast cancer. The Women’s Health Initiative studies also found no increase in breast cancer risk in women using systemic estrogen-only HRT.

Only combined therapy (estrogen and progestin) has the chance of increasing the risk slightly. The main risk factors however are obesity, smoking, and alcohol intake.

False: “herbal medicine always works just as well”
No. The fact that something is plant-based does not mean it is harmless, effective, and superior to mainstream medicine. There are little to no reliable findings about the prolonged use and effectiveness of most herbal medicines, although there are a few that can be used against milder cases of hot flashes, for example black cohosh (Cimicifuga racemosa). It has been shown to be effective in alleviating mild to moderate hot flashes and to have a positive effect on bone metabolism and vaginal mucosa.

False: "Bioidentical hormones are natural and not synthetic"
Do not let the terminology mislead you: these hormones have exactly the same structure as the body's own female hormones, estrogen and progesterone, even if the latter sound more effective than the "synthetic" hormones of the pharmaceutical industry. In reality, these conventional hormones have the same structure as the body's own and therefore also the same positive or side effects. Since synthetic hormones are engineered in the laboratory, they have the advantage of being very pure and containing no unwanted by-products.

References:
• https://www.breastcancer.org/risk/risk-factors/using-hormone-replacement-therapy
• https://pubmed.ncbi.nlm.nih.gov/35357369
• https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413
• https://www.endocrine.org/-/media/endocrine/files/advocacy/position-statement/position_statement_compound_biomedical_hormone_therapy.pdf