Hi Ann - I have been on HRT since perimenopause and am now 63 and was still on it until a few months ago when I had “pellets” put in and had a horrible experience with them. I have since been off any HRT for maybe two months and am trying to make the right decision whether to go back on them based on. I would be taking them for my brain health and at the right dosage I had no negative effects. (150 Estrodial and 100 progesterone.) I don’t have any known history of breast cancer and while my mother passed from a blood clot we believe, she was also in late stages of dementia and was mostly immobile. My doctor shared that she believes current research shows HRT is valuable as you share during perimenopause and perhaps menopause - it may have more risks than rewards for post menopausal women. What are your thoughts?
Hi Bonnie, it sounds like you have a doctor who is willing to work with you on this. I applaud your choice to go off pellets. Perhaps a cardiac workup would be a reasonable thing to do to rule out any evolving issues with athersosclerotic heart disease, one of the concerns we have with women over 60 on HRT.
Thank you Ann. After much research I decided to stay on an HRT just NOT pellets and did get the cardiac work up and have started both regular exercise and am actually trying the GLP 1 and am finally losing the added weight - so your most recent article was reassuring! I’ve also been taking your recommended Neuroreserve and look forward to you having another getaway in Sicily that I can attend. Thank you for all that you are doing.
Seeing my doctor in early January to discuss starting estrogen therapy. Is there a blood test that can determine what menopausal phase you are in or how long you have been in menopause?
I had a hysterectomy (left ovaries in) when I was 48 due to adenomyosis. No hormone replacement due to fear of old studies.
I am now 62 and have no idea how far out I am from start of actually menopause. I started having more hot flashes, can't sleep, mood swings, weight gain etc in the last two years. Hot flashes off and on for years.
I know you can't give medical advice but I would like more ammunition going into my appointment.
Hi Rachel! Blood testing is not helpful or necessary in most cases to diagnose menopause unless it's very early or in a few other medical situations. You may want to ask about being tested for thyroid disease, though, especially if you haven't had that checked; many of the symptoms can overlap with menopausal ones.
This topic is so important and I find it can be very confusing. For so long I was scared of HRT due to the increased risk of breast cancer, which seemed to make headline news stories. However, after finding out I am an APOE4 carrier, I have been doing more research on this topic and I need to address this situation as soon as possible. We need to share this information with as many women as possible so they can make the best informed decision for their individual health situation. Thank you for sharing this valuable information.
Sadly, I was one of those scared off by the WHI so went cold turkey through menopause. So many things I think back on now - how secretly scared I was going through my workday because I couldn't concentrate, couldn't process information, couldn't remember things anymore, and the anxiety that caused. Lordy. I didn't realize the connection then. Anyway, fast forward a decade and I'm now trying to make some course corrections, and the info you offer is helping so much! Thank you! BTW, tonight I'm cooking from pg 192 in your cookbook :-)
So sorry to hear that Beth! I was practicing menopausal medicine when the WHI came out and spent a lot of time with women suffering like you did. For long term health benefits, taking HRT can be important but it's certainly not the only thing. At this point, nutrition and exercise are where the focus should be. Enjoy the recipe!!!
Just asked this question of my GYN NP about a month ago — wish I had read this article before I asked about HRT. She basically said since all my annual bloodwork is very good (grateful) and I’m not experiencing symptoms there wouldn’t be a reason to start HRT. I’m 64, so am I too far past menopause to get the benefits? Love my cookbook by the way!!
Hi Pamela. I'm so happy you love the book! I would lean on the Critical Window hypothesis here, as it guides both safety and efficacy. Starting within 5 years of menopause (the time of the last period) is optimal. Sometimes that can be stretched by a few years for special circumstances. More than 10 years past menopause? It's best to focus on other things you can do, like a brain healthy diet, exercise (especially weight bearing for your bones), good sleep, and building cognitive reserve.
Just past ten years! The good news for me is I’ve been following the brain health diet, getting good sleep, and exercising in a dedicated manner for the past year. Also taking my Relevate every day. I’m not sure what you mean by building cognitive reserve but I’ll look that up. (Making coffee, date, and oat bars tomorrow AND savory quick bread and I’m very excited about it! Love the spinach tofu ricotta too!)
All good stuff. Glad you are on the Relevate, too. Cognitive reserve is all the intellectual capital you build to make your brain resilient to Alzheimer's. Should I write about this in an upcoming post?
Where can I find the event details? I should be around in April and would love to attend and meet! And thank you so much for getting my cookbook - yours is on its way home as well :)
We are finalizing everything and I'll post here first! Also on my Instagram @brainhealthkitchen and the Book page of my website: brainhealthkitchen.com
Thank you for shining a light on this topic and sharing important research and information (HRT). Most OB/GYN practices and the specialties of the MDs are focused on women's reproductive years that when those years are behind you, finding an GYN whose specialty is Menopause (and perimenopause) is an incredible challenge. I hope your article starts to change this!
Thank you! Yes, I hope this is helpful! Those doctors are out there and they may not specialize in menopause but ob/GYNs over age 50 will have the experience women need.
Great question Melissa. I don’t have a Bay Area referral but maybe someone else does? I tend to agree with your doctor, as hormone testing can be really expensive without adding much. It’s important in certain circumstances, like diagnosing menopause, especially early menopause. But it doesn’t help your doctor adjust HRT dose and formula--that is done based on how you feel and whether or not you have any side effects.
Hi I am in the Bay Area and have been looking for an integrative medicine Dr for years. Has anyone found one they like? My OB is not opposed to HRT but doesn’t believe in monitoring through blood tests. Is there merit to this?
Annie- this article is fabulous. So clearly articulated and practical. Loved the look into your book your life! The SF bookstores you visited are some of my favorites!
Thank you so much for your post and while on book tour too!! A few years ago I was having the typical menopause symptoms..night sweats, poor sleep, foggy brain and a bit of anxiety. Luckily my Gynecologist put me on HRT and it has been wonderful. I do worry about Alzheimer's though because my mom had it. I'm trying to do all I can to hopefully prevent it, so this latest data on HRT was awesome to hear. Thank you again. I truly appreciate ALL that you do.
Would HRT be an absolute no if my mom had breast cancer twice at age 50 and 55. She developed Alzheimer’s and just passed away 3 months ago at age 81. I am 50 and I want do do everything I can to avoid it. If I had to choose I would rather fight breast cancer than have Alzheimer’s. It was so awful.
Having breast cancer personally is a definite no in almost all situations. (There are a few exceptions.) Having a family history of breast cancer is NOT a definite no. Find a qualified doctor to discuss.
Thank you for this newsletter! I have taken a few perimenopause/menopause courses to learn about hormones, functional axis that they work (aderynls, thyroid, hypothyroid..) and HRT. I find it very hard for some physicians and NPs to prescribe women HRT stating "it could cause uterine cancer". They are still stuck on that 2002 study! I arm my patients with information from NAMS, research papers and encouraged them to go back to their health care provider and discuss HRT further. With reluctance, their provider will prescribe. Women should not have to suffer with perimenopausal/transition/menopause symptoms, current research is very clear on the benefits!
Thanks Norene. I love hearing your experience with this. Yes, unfortunately, women have to "make a case" for why they want HRT. The silver lining is it does help a woman zero in on her goals with therapy, but it shouldn't be so difficult to get a prescription.
Hi Susie. I am so sorry you had to go through all this. Yes, for women who have had cancer it is very individual approach, depending on the type of cancer, stage, cell type, family history, all of those things. Having a top-notch oncologist is paramount! Nice to hear you are feeling better.
Hi Ann - I have been on HRT since perimenopause and am now 63 and was still on it until a few months ago when I had “pellets” put in and had a horrible experience with them. I have since been off any HRT for maybe two months and am trying to make the right decision whether to go back on them based on. I would be taking them for my brain health and at the right dosage I had no negative effects. (150 Estrodial and 100 progesterone.) I don’t have any known history of breast cancer and while my mother passed from a blood clot we believe, she was also in late stages of dementia and was mostly immobile. My doctor shared that she believes current research shows HRT is valuable as you share during perimenopause and perhaps menopause - it may have more risks than rewards for post menopausal women. What are your thoughts?
Hi Bonnie, it sounds like you have a doctor who is willing to work with you on this. I applaud your choice to go off pellets. Perhaps a cardiac workup would be a reasonable thing to do to rule out any evolving issues with athersosclerotic heart disease, one of the concerns we have with women over 60 on HRT.
Thank you Ann. After much research I decided to stay on an HRT just NOT pellets and did get the cardiac work up and have started both regular exercise and am actually trying the GLP 1 and am finally losing the added weight - so your most recent article was reassuring! I’ve also been taking your recommended Neuroreserve and look forward to you having another getaway in Sicily that I can attend. Thank you for all that you are doing.
Happy to hear all of this!
Seeing my doctor in early January to discuss starting estrogen therapy. Is there a blood test that can determine what menopausal phase you are in or how long you have been in menopause?
I had a hysterectomy (left ovaries in) when I was 48 due to adenomyosis. No hormone replacement due to fear of old studies.
I am now 62 and have no idea how far out I am from start of actually menopause. I started having more hot flashes, can't sleep, mood swings, weight gain etc in the last two years. Hot flashes off and on for years.
I know you can't give medical advice but I would like more ammunition going into my appointment.
Hi Rachel! Blood testing is not helpful or necessary in most cases to diagnose menopause unless it's very early or in a few other medical situations. You may want to ask about being tested for thyroid disease, though, especially if you haven't had that checked; many of the symptoms can overlap with menopausal ones.
This topic is so important and I find it can be very confusing. For so long I was scared of HRT due to the increased risk of breast cancer, which seemed to make headline news stories. However, after finding out I am an APOE4 carrier, I have been doing more research on this topic and I need to address this situation as soon as possible. We need to share this information with as many women as possible so they can make the best informed decision for their individual health situation. Thank you for sharing this valuable information.
YES! I could not have said it better myself Kelly!
Sadly, I was one of those scared off by the WHI so went cold turkey through menopause. So many things I think back on now - how secretly scared I was going through my workday because I couldn't concentrate, couldn't process information, couldn't remember things anymore, and the anxiety that caused. Lordy. I didn't realize the connection then. Anyway, fast forward a decade and I'm now trying to make some course corrections, and the info you offer is helping so much! Thank you! BTW, tonight I'm cooking from pg 192 in your cookbook :-)
So sorry to hear that Beth! I was practicing menopausal medicine when the WHI came out and spent a lot of time with women suffering like you did. For long term health benefits, taking HRT can be important but it's certainly not the only thing. At this point, nutrition and exercise are where the focus should be. Enjoy the recipe!!!
Just asked this question of my GYN NP about a month ago — wish I had read this article before I asked about HRT. She basically said since all my annual bloodwork is very good (grateful) and I’m not experiencing symptoms there wouldn’t be a reason to start HRT. I’m 64, so am I too far past menopause to get the benefits? Love my cookbook by the way!!
Hi Pamela. I'm so happy you love the book! I would lean on the Critical Window hypothesis here, as it guides both safety and efficacy. Starting within 5 years of menopause (the time of the last period) is optimal. Sometimes that can be stretched by a few years for special circumstances. More than 10 years past menopause? It's best to focus on other things you can do, like a brain healthy diet, exercise (especially weight bearing for your bones), good sleep, and building cognitive reserve.
Just past ten years! The good news for me is I’ve been following the brain health diet, getting good sleep, and exercising in a dedicated manner for the past year. Also taking my Relevate every day. I’m not sure what you mean by building cognitive reserve but I’ll look that up. (Making coffee, date, and oat bars tomorrow AND savory quick bread and I’m very excited about it! Love the spinach tofu ricotta too!)
All good stuff. Glad you are on the Relevate, too. Cognitive reserve is all the intellectual capital you build to make your brain resilient to Alzheimer's. Should I write about this in an upcoming post?
Definitely! I’m an avid reader but sometimes I wonder what other things I could be doing. Looking forward to learning more!
Are you coming to NYC for your book tour?
Will you be there in April? I would love to meet you. I have been on book tour but can't wait to get home because your book will be waiting for me:)
Where can I find the event details? I should be around in April and would love to attend and meet! And thank you so much for getting my cookbook - yours is on its way home as well :)
We are finalizing everything and I'll post here first! Also on my Instagram @brainhealthkitchen and the Book page of my website: brainhealthkitchen.com
Yes! I will be speaking at the JCC in Manhattan in April.
Thank you for shining a light on this topic and sharing important research and information (HRT). Most OB/GYN practices and the specialties of the MDs are focused on women's reproductive years that when those years are behind you, finding an GYN whose specialty is Menopause (and perimenopause) is an incredible challenge. I hope your article starts to change this!
Thank you! Yes, I hope this is helpful! Those doctors are out there and they may not specialize in menopause but ob/GYNs over age 50 will have the experience women need.
Great question Melissa. I don’t have a Bay Area referral but maybe someone else does? I tend to agree with your doctor, as hormone testing can be really expensive without adding much. It’s important in certain circumstances, like diagnosing menopause, especially early menopause. But it doesn’t help your doctor adjust HRT dose and formula--that is done based on how you feel and whether or not you have any side effects.
Hi I am in the Bay Area and have been looking for an integrative medicine Dr for years. Has anyone found one they like? My OB is not opposed to HRT but doesn’t believe in monitoring through blood tests. Is there merit to this?
Annie- this article is fabulous. So clearly articulated and practical. Loved the look into your book your life! The SF bookstores you visited are some of my favorites!
Thank you Sally! I am fully enjoying the book tour! Especially getting to see all these amazing bookstores around the country. SF has so many!
Thank you so much for your post and while on book tour too!! A few years ago I was having the typical menopause symptoms..night sweats, poor sleep, foggy brain and a bit of anxiety. Luckily my Gynecologist put me on HRT and it has been wonderful. I do worry about Alzheimer's though because my mom had it. I'm trying to do all I can to hopefully prevent it, so this latest data on HRT was awesome to hear. Thank you again. I truly appreciate ALL that you do.
Thank you Janet! Good to hear you are doing everything to reduce your Alzheimer's risk!
Would HRT be an absolute no if my mom had breast cancer twice at age 50 and 55. She developed Alzheimer’s and just passed away 3 months ago at age 81. I am 50 and I want do do everything I can to avoid it. If I had to choose I would rather fight breast cancer than have Alzheimer’s. It was so awful.
Having breast cancer personally is a definite no in almost all situations. (There are a few exceptions.) Having a family history of breast cancer is NOT a definite no. Find a qualified doctor to discuss.
Thank you for this newsletter! I have taken a few perimenopause/menopause courses to learn about hormones, functional axis that they work (aderynls, thyroid, hypothyroid..) and HRT. I find it very hard for some physicians and NPs to prescribe women HRT stating "it could cause uterine cancer". They are still stuck on that 2002 study! I arm my patients with information from NAMS, research papers and encouraged them to go back to their health care provider and discuss HRT further. With reluctance, their provider will prescribe. Women should not have to suffer with perimenopausal/transition/menopause symptoms, current research is very clear on the benefits!
Thanks Norene. I love hearing your experience with this. Yes, unfortunately, women have to "make a case" for why they want HRT. The silver lining is it does help a woman zero in on her goals with therapy, but it shouldn't be so difficult to get a prescription.
Hi Susie. I am so sorry you had to go through all this. Yes, for women who have had cancer it is very individual approach, depending on the type of cancer, stage, cell type, family history, all of those things. Having a top-notch oncologist is paramount! Nice to hear you are feeling better.