An Experience with Hormone Replacement Therapy (HRT)
When I read the book What Your Doctor May Not Tell You About Menopause by Dr. John R. Lee, I learned much about the benefits and side effects of hormone replacement therapy (HRT) during menopause. While the book had a plethora of information, I also found it important to hear about experiences directly from women.
My aunt Mary graciously shared her story about being on HRT and has allowed me to publish it on my blog.
When Mary was in her early thirties, she was diagnosed with thyroid cancer. She underwent a radioactive iodine treatment, which was successful, but at the time, her doctor never mentioned that she needed to wait 3-5 years before trying to have children, as the radiation could have impacted her ovaries. About three years after the treatment, she started trying for children, but was met with infertility, no sleep, and extreme hot flashes.
Her doctor prescribed an estrogen patch, and within three days, she felt like herself again, and her hot flashes had stopped. When infertility continued, her doctor tested her FSH. The test showed that her FSH was extremely high, which indicated menopause–at the age of 37.
This was devastating news, as her doctor told her she would not be able to conceive. Mary later found out that the radioactive iodine treatment was shown to lead to early menopause. She was not informed of this prior to the treatment, and if she knew that the treatment could have affected her fertility, she may have chosen a different path.
Mary was then prescribed estrogen in the form of the Climara patch and a 200 mg pill of progesterone. She felt comfortable with HRT because she was in early menopause and her body wasn’t creating a sufficient amount of hormones, which was leading to menopause symptoms like hot flashes. Still, the doctors did not explain HRT to her and did not continuously monitor her hormone levels; she was prescribed a seemingly random dosage.
HRT did help her menopausal symptoms: the hot flashes were minimal and tolerable, and she had better sleep. However, she also experienced weight gain and daily bleeding (for nearly ten years!). The bleeding caused anemia and a need to take iron pills. Mary thought the side effect of bleeding was due to excess estrogen.
During her ten years on HRT, she did more research into bioidentical hormones. She tried a new physician who performed saliva tests to measure hormones (which, according to What Your Doctor May Not Tell You About Menopause, is the best type of hormone test). With a compound pharmacy, she could receive the exact amount of hormones she needed, and they were also bioidentical, which means that they are closer to the hormones that are naturally made in the body, unlike synthetic progestins.
Mary went back to her OBGYN who had originally prescribed HRT, and the OBGYN dismissed her request about natural hormones. Mary found out later that the OBGYN had actually prescribed her natural hormones from the start, which the OBGYN did not realize.
She would try to wean off HRT a couple of times, but then she would experience more hot flashes and would need a higher level of estrogen. When Mary turned 50, she completely weaned herself off of HRT.
In the end, she said that HRT was worth pursuing, as it tremendously helped with her menopause symptoms. Informed consent, physician education, and regular hormone testing (to determine dosage) could have greatly improved her experience with HRT.
She also is more than willing to share her experiences with women who have thyroid cancer or are entering menopause, as trustworthy information on treatments can be hard to find. Mary’s story is a powerful reminder of how crucial it is to have clear, compassionate, and informed care, especially during menopause.
As women, we always need to advocate for ourselves, especially when it comes to women’s health. It’s unfortunate that physicians sometimes dismiss our experiences or do not explain all of the side effects of treatments. Luckily, more information about fertility is becoming more available, and hopefully women will be able to make an informed decision on what treatment is best for them.
Disclaimer: For informational purposes only. This is not medical advice.