Hormone replacement is not a “set-it-and-forget-it” situation

I often talk about how we need to check in with our diet and lifestyle habits as we age to make sure that they are still working for us.  Are we getting enough protein, fiber, and colorful vegetables? Are we drinking enough water? Building muscle, moving throughout the day, and getting the right kind of cardio? Are we going to be early and getting morning sun? …

Sometimes it feels like thriving in midlife takes a lot of intentional activity, so much so that I changed my Peloton leaderboard name to DoinAllTheThngs. 🤣💪🚴🏼‍♂️

As someone who believes that diet and lifestyle habits are foundational to health and wellness, especially as we age, I really try to optimize my diet and lifestyle (most of the time), and I decided to go on menopausal hormone replacement therapy (MHT). I want to feel good now and as I age, and the benefits outweigh the risks for me.

Current estimates suggest fewer than 5% of postmenopausal women in the U.S. are taking any MRT.  Yet, if you are like me, your discussions with clients, friends, family, and social media feeds are full of talk about MHT.

In my discussions with women, they are mostly wondering about the benefits and risks (of taking MHT or not taking it), whether they are good candidates for MHT, when they should consider it (are they too young or too old), and whether they have a good provider whom they trust and would recommend.

I recommend that women do their research, speak with their provider(s), and make an informed decision about what is right for them. There is no one right diet for every person, there is no one right way to do menopause, MRT, and beyond for all women.

And if you do decide to go on hormone replacement…

Hormone replacement is not a “set-it-and-forget-it” situation

I have had many clients who have told me that they get their MRT prescriptions and have never had their levels tested or had a follow-up conversation with their practitioners.

Today, I want to share a story about my experience with MRT.

If you have never seen an estrogen patch, it looks like a clear Band-Aid. Depending on the dose, the size ranges from a fingernail to a quarter. Sometimes women struggle to get them to stick, and other times they have trouble removing them, but for the most part, they are pretty easy to use, and you can’t tell one brand from another by their appearance.

I have my prescription on autofill, and every few months, the pharmacy fills the order with a different brand. I never thought much of it, but I started noticing that my energy was a little low and my sleep was a little more challenging.

Then I started noticing that my CGM (continuous glucose monitor) readings were inching up in the early morning hours. I asked my doctor to run some tests, and we saw my cholesterol numbers were slightly higher, and my estrogen levels had slid down.

I tried a higher dose of estrogen, and my levels didn’t change. I talked with my doctor about options, and I wanted to pursue staying on a patch instead of trying other forms of estrogen replacement because of the cardiovascular, bone, and other protection it offers.

My doctor prescribed a different brand of estrogen patch. After calling around to several other pharmacies, I found it in stock and tried it. I went in for another blood test, and my estrogen levels had decreased.

We went through the same process again, and I tried a third brand of patch, and my levels finally started increasing. Once I found the right patch for me, we were ready to work on getting the right dose. This process took several months and several rounds of blood tests.

Had I not asked for testing, I would not have known that I only absorb the estrogen from one brand of patch. According to my doctor, I am not the only one with this sensitivity. My challenge is that the pharmacies can’t always get a specific brand of patch, but I am working through that.

TLDR: If you are taking MRT, it’s crucial to get your levels tested 
If you’re feeling “off,” don’t just guess or wait it out. Get tested to be sure your MRT is actually doing what it’s supposed to.

And I would not leave this advice to just MRT; the same advice goes for any medication. 

Sometimes you can’t tell if your HRT is not at an optimal level. I mean, how many of us are tired and not sleeping great? Some of the benefits of hormone replacement are subtle, while others help address long-term issues, such as protecting your bones and cardiovascular system.

Many of us have had to advocate for our health if we wanted to go on MRT. We need to continue to advocate for ourselves once we are on these medications to ensure that our MRT is working and at an optimal dose for us.

Next Steps
If you’ve been meaning to eat better, boost your energy, or find a way of eating that truly supports you in midlife, now’s the time.

Let’s work together to create a plan filled with nourishing foods, sustainable habits, and support you every step of the way.

If you are curious about how individualized one-on-one nutrition counseling can benefit you, or if you’re a previous client needing a check-in or reboot, click here to book a free exploratory call and learn more about how we can work together.