The ability to adjust a woman’s hormones manually, via hormone replacement therapy (HRT), is very new in the larger scheme of human existence. As a result, researchers continually find pros and cons to the variety of options available- as well as dosage and formulas.

Currently, one of the biggest debates is whether patches or pills are the safest option, with the least amount of harmful side effects.

Hormone Replacement Therapy Regulates Hormone Imbalance During Menopause

Menopause typically begins about 10 years before periods cease altogether. The initial phase, called perimenopause, begins in the 40s and the symptoms can creep up on you. Most women weather the transition just fine, but are likely to experience symptoms such as:

If you’re able to make the transition without hormone supplements, that’s the ideal – and things like a menopause-focused diet and exercise are some of the best tools to do that. However, some women need more support.

Which is Safer: The Patch or The Pill?

While some medical experts are leaning towards the patch (or gel/cream forms) over the pill, most doctors agree that that case-by-case management of HRT, that focuses on the appropriate dose per patient is the best way to minimize patient risk, regardless of whether women are taking oral or topical forms.

Pills may increase your chance of blood clots (VTE)

In recent studies, women who use pill forms of HRT are more likely to experience serious blood clots (venous thromboembolism or VTE), because oral pills are processed by the liver, and this increases the risk of clotting.

However, that particular side effect is already considered rare, and the increased risk associated with clots from taking hormone pills was only minimally higher (15% or less) than the risk of experiencing VTE with patches or without any hormone replacement therapy at all.

High estrogen doses increase other risks

What most doctors are learning through reviews of cumulating data pertaining to HRT is that accurate dosing is key to minimizing risks of harmful HRT side effects.

UCLA and other medical research centers have found direct correlations with higher-doses of estrogen and increased risk of heart attacks, strokes, and breast cancer. When reviewing eight consecutive years of medical records, for more than 45,000 postmenopausal women between the ages of 50 and 79, researchers found:

  • Women taking oral estrogen at doses of .625 mg per day, in combination with progestogen, had lower risks of negative outcomes or side effects than women taking more than .625 mg of estrogen per day.
  • They found no difference in health risk between women taking oral forms of estrogen, versus those using patches or pills – as long as they remained at the .625 mg per day dose or less.

This study is believed to be the most comprehensive study performed in the U.S. and is becoming the new standard when reviewing HRT options and deciding which method – if any – of HRT is right for you.

All Things in Moderation – Including HRT

Perhaps the moral of this story really goes back to the idea of “all things in moderation.” When reviewing whether to pursue HRT, consider:

  • Speaking with your doctor about how long it makes sense to remain on HRT before easing back to no HRT after menopause. Having an exit strategy is a smart way to ensure your body doesn’t wind up receiving more estrogen than is good for it.
  • Are symptoms so severe that you really need it, or is it worth biding your time for a while longer to see if they subside as your hormones achieve a better postmenopausal balance?
  • Can you start with the lowest dose possible and work up to a moderate form (if needed), rather than starting at the top and dialing back?

Interested in working with an OB/GYN team who can walk you through your HRT options and support you in choosing the best version for you? Schedule a consultation with Overlake.