HRT or Not? How to Choose What’s Right for You

HRT or Not? How to Choose What’s Right for You

“I thought HRT was dangerous.”
“My friend swears by it. My doctor told me he doesn’t believe in it.”
“I just want to know what’s safe—and what’s not.”

Hormone Replacement Therapy (HRT) is one of the most debated, misunderstood, and emotionally loaded topics in menopause care.

For some women, it’s a lifeline. For others, it has adverse effects, or it feels like a risk they’re not willing to take. And for most, it’s confusing—thanks to decades of conflicting information, shifting medical advice, and one big, flawed study that scared an entire generation away from estrogen.

If you’re unsure about HRT, you’re not alone.
And you don’t have to make a decision today—or make it alone.

What Is HRT Exactly?

HRT stands for Hormone Replacement Therapy. It involves supplementing the hormones that naturally decline during perimenopause and menopause—mainly estrogen, and often progesterone (if you have a uterus), and sometimes testosterone.

HRT can help manage symptoms like:

·        Hot flashes

·        Night sweats

·        Sleep disruption

·        Vaginal dryness

·        Fatigue

·        Brain fog

But it’s not just about symptoms. There’s growing evidence that estrogen plays a critical role in long-term health—especially for bones, brain, and cardiovascular function.

It’s also important to know that not all HRT is the same:

·        Bioidentical hormones are structurally identical to those your body produces

·        Synthetic hormones (like those used in older studies) are not

·        Transdermal delivery (patches, gels, creams) tends to be safer than oral pills, especially when it comes to clotting risks

The Truth About the 2002 WHI Study

Let’s clear this up once and for all.

The Women’s Health Initiative (WHI) study, published in 2002, claimed that HRT increased the risk of heart disease and breast cancer. It made headlines worldwide—and led to the almost full discontinuation of HRT.

The study has since been criticized as biased and methodologically flawed.  For instance:

·        The women in the study were, on average, 63 years old

·        Most were well past menopause, without symptoms

·        They received synthetic estrogen and progestins (Premarin + Provera)

·        HRT was delivered orally, which carries more clotting risk than transdermal forms

What the WHI did is give synthetic hormones to women long past menopause—and applied those results to any form of HRT for all women, of any age.  It’s the equivalent of giving white bread to people with gluten sensitivity, watching them get sick, and then banning all forms of wheat for everyone.

Modern HRT typically uses bioidentical hormones, which match the hormones that naturally occur in your body:

·        Transdermal Estrogen:  (different from synthetic estrogen) mainly estradiol and sometimes estriol, which are 2 of the 3 naturally occurring estrogens in your body

·        Oral Progesterone:  (different from progestins) to balance it in women that still have a uterus

·        Transdermal Testosterone:  less common but gaining traction. 

While most of the WHI findings have now been retracted, the original, inaccurate claims are what continues to control the narrative, and practice, through the medical community.   Modern HRT is not the same. And it’s time we stop punishing women with outdated science.

What the Research Says Now

There is  a growing body of evidence that hormonal balancing through bioidentical HRT can be safe and beneficial on multiple fronts: 

·        It can improve quality of life by reducing symptoms and improving sleep, mood, and libido

·        It plays a critical role in preventing bone loss and reducing fracture risk

·        It can protect and improve cardiovascular health

·        There is emerging evidence that estrogen may have neuroprotective effects, possibly lowering the risk of Alzheimer’s disease and dementia

·        Some studies even show that HRT may be safe—and beneficial—for some breast cancer survivors. 

The evidence is evolving. It’s time our conversations with our healthcare providers did too.

So... Should You Try HRT?

That depends on:

·        Your symptoms

·        Your age and health history

·        Your personal goals

·        Your risk tolerance

·        Your values

This is not a one-size-fits-all decision.

You deserve accurate information, and a supportive healthcare provider so  you can discuss and decide what is best for you. 

How Bastet Rising Can Help

We’re not here to push HRT—or any solution.
We’re here to help you build the evidence to make confident, informed choices in partnership with your healthcare provider

With Bastet Rising, you can:

·        Track your symptoms before, during, or without HRT

·        Log your other treatments, supplements, and more

·        See what’s improving—and what’s not

·        Build a record that helps you and your provider make decisions that evolve with your needs

Whether you’re exploring HRT, currently on it, or looking for other options—tracking is your superpower.

The Best Treatment Is the One That’s Right for You

You don’t need to rush this decision.
You don’t need to defend it either.

Whether you say yes or no to HRT or defer a decision until later—you’re not failing. You’re leading your own health story.

Bastet Rising is here to help you track your symptoms, assess your options, and turn your experience into evidence you can trust.

You already have the clues

Track them

See the patterns

Speak your Turth

That’s how we rise

Sources for Further Reading

·        Estrogen Matters by Avrum Bluming and Carol Tavris

·        Lisa Mosconi, PhD — research on estrogen and brain health

·        NAMS 2022 Position Statement on Hormone Therapy (PDF)