HRT alternatives

If you are going through menopause, you have likely been offered hormone replacement therapy, or HRT to provide synthetic hormones and subside any symptoms. While HRT is one solution, many women prefer other alternatives to HRT such as lifestyle changes or natural HRT alternatives such as supplements. Within this guide we'll cover some of the best alternatives to HRT so you can find what's best for you.

What is HRT?

Called hormone replacement therapy, it's a widely used treatment for menopause. When approaching menopause, your ovaries will produce less of the hormone estrogen, which results in a range of symptoms including hot flushes, night sweats, vaginal dryness, stress and mood swings.

The purpose of HRT is to replace the body's natural supply of hormones with synthetic estrogen and progestogen to not only stimulate the lining of the womb but protect it as well. There are various types of HRT available such as cyclical, continued combined and estrogen only. For more information read our guide on which HRT is right for you.

The pros and cons of HRT

Some women swear by HRT and have found great comfort in relief from their symptoms of night sweats, insomnia, continual hot flushes and vaginal dryness. The main benefit of HRT is it can help relieve these symptoms, but HRT can also prevent osteoporosis which is more common after menopause due to the weakening of bones.

However there are some disadvantages of HRT. It can cause common side effects such as headaches, abdominal pain and vaginal bleeding. However, if you've got a history of breast, ovarian or womb cancer or blood clots, liver disease, or high blood pressure then you may be recommended an HRT alternative instead. This is because HRT increases the risk of certain cancers so discuss this with your GP.

Whether you are pointed in the direction of an alternative to HRT, or you prefer the natural route, there are lots of options for you. Many people choose alternative HRT treatments if they want to target a specific symptom, HRT isn't the best option for them, or alternatives to HRT are often believed to be safer without risks or side effects.

What are the alternatives to HRT?

A few HRT alternatives can be classified as the following:

• Lifestyle changes: these are ways that you can control symptoms in your day-to-day life.
• Herbal medicine and supplements: these use plants, plant extracts or supplements with vitamins and minerals to relieve symptoms.
• Alternative medicine: a range of therapies used that fall outside the mainstream healthcare, such as acupressure, acupuncture and homeopathy.
• Complementary therapy: these are interventions that are usually used alongside conventional medicine such as aromatherapy and HRT or supplements.
• Non-hormonal medicine: prescribed treatments and medicines.

Lifestyle alternatives to HRT

If you are unable to take hormone replacement therapy, there are a few lifestyle changes you can make before trying other HRT alternatives such as medicines. These can also be helpful alongside HRT or other treatments.

Lifestyle changes include:

• Regular exercise
• Have a healthy and balanced diet
• Wear loose clothes
• Sleep in a cool room
• Cut down on alcohol, caffeine and spicy foods
• Don't smoke or vape
• Try vaginal lubricants and moisturizers

Alternative medicine for menopause

Whether you are looking for an alternative to HRT or a complementary medicine for menopause and want to combine alternative with modern medicines, there are a few choices for you:

• Acupressure:This is a form of alternative therapy in which manual pressure is used to stimulate specific points on the body. Studies show that acupressure can help in reducing the number and severity of hot flashes, night sweats, and stress and anxiety from menopause.
• Acupuncture:Is a treatment from ancient Chinese medicine and is where fine needles are inserted at certain sites in the body for therapeutic or preventative natures, such as relieving pain and treating the effects of menopause. Studies have shown that acupuncture can increase hormone levels which in turn helps relieve symptoms from menopause.
• Aromatherapy:The practice of using essential oils for therapeutic benefits. In menopausal treatments, aromatherapy may help to improve well-being and some essential oils may help with specific symptoms, results found that lavender or neroli had great effects on reducing symptoms, as well as aromatherapy massage with mixed oils. However there is still limited evidence.
• Yoga: Generally involving physical poses or movement sequences, conscious breathing regulation and mindfulness techniques, studies concluded that yoga does have short-term effects on psychological symptoms in menopause and may help to decrease insomnia.
• Hypnosis: Involving a deep state of focused attention and has been used for a range of reasons, including treating menopause symptoms, such as hot flashes, sleep quality and sexual function.
• Cognitive Behavioral Therapy: CBT is a psychological intervention that focuses on changing the way you think and behave to alter symptoms. A study has shown that by educating, motivating and relaxation techniques through CBT hot flashes and other symptoms have reduced.

Herbal alternatives to HRT

Also known as natural HRT alternatives, these are made of plants or plant extracts that contain hormones that act in a similar way to estrogen, and some even balance estrogen and progesterone levels. These natural alternatives to HRT may help alleviate menopausal symptoms.

Black cohosh

This medicinal herb has been used for centuries to support menopausal women, and may help with hot flushes, depression, night sweats and vaginal dryness. Research has shown an improvement in symptoms in up to 80% of women using black cohosh within six to eight weeks.

There's been a lot of controversy over this herb, with some calling into question the safety of black cohosh on breast tissue. However, most recent research suggests that black cohosh is a selective oestrogen receptor modulator (SERM), which means that it stimulates only certain oestrogen receptors in the body: namely, the bones and the brain, and not womb or breast tissue.

The best way to take black cohosh is as a supplement, and some menopause-supporting supplements contain this herb. Or you could visit your local medical herbalist who can make you a bespoke tincture containing black cohosh.

Phytoestrogens

Phytoestrogens are essentially plant-based molecules that possess estrogen-like activity. These can be found in foods such as soybeans, beansprouts, chickpeas, flaxseed, sesame seeds and wholegrains. Including these in your diet or through herbal supplements, may help to moderate symptoms of menopause due to their effect on oestrogen receptors on the cell membrane. In cases where oestrogen levels are low, they lock on to receptors and stimulate a mild oestrogenic effect. Where there is an oestrogen excess, the phytoestrogens block cell receptors.

Milk thistle

The active ingredient in milk thistle is a bioflavonoid called silymarin, which can help to sup-port hormonal balance through its protective action on the liver. Any excess hormones we have in our body are detoxified and excreted via the liver and gut, which makes milk thistle an excellent herb to help support hormonal balance.

Evening primrose oil

A common treatment for a number of conditions, the flowers and seeds of the Evening Prim-rose plant are pressed to make oils that are high in omega 6 and GLA which are essential fatty acids that improve dry itchy or inflamed skin, it can reduce redness, hot flashes as well as any discomfort from menopause.

At Healthspan, we have a range of herbal medicines that can help soothe menopausal symptoms and act as the perfect alternative to HRT. With added vitamins and minerals, check out our full range of herbal medicines from valerian, black cohosh, and more.

Vitamin alternatives to HRT

Supplements are a great alternative to HRT and can be found as herbal or with vitamins and minerals. Many of our natural HRT alternatives offer both, but vitamins to look out for are:

Vitamin E

Around 75% of menopausal women experience hot flushes, and research has shown a significant reduction in their severity and frequency from taking 400IU of vitamin E per day. The same dose of vitamin E has also been shown to help reduce vaginal dryness. Good food sources include avocados, seed oils, nuts, leafy green vegetables, whole grains and wheat germ. If you opt for a vitamin E supplement, look for one that contains d-alpha-tocopherol, as this is better absorbed.

Omega-3 essential fatty acids

The signs of omega-3 deficiency are similar to many symptoms experienced during menopause: dry skin, fatigue, depression, and aching joints. Omega-3 essential fats also support hormone balance, and have a lubricating effect in the body, so may help with vaginal dryness, and have been linked to a reduction in the risk of breast cancer. Good food sources include oily fish (salmon, mackerel, herring, sardines, seafood and fresh tuna), nuts, seeds and green leafy vegetables.

If you don't like fish, it's worth supplementing fish oil daily. We have a range of Omega-3 supplements which are great to add into your diet.

Vitamin D

Vitamin D is an essential nutrient for supporting bone density, which decreases during menopause. For a good alternative to HRT, try to increase your vitamin D levels as it's essential for calcium absorption. You can get vitamin D from various food and drinks and the sun, however it can be difficult to get enough sun to make sufficient vitamin D, and our ability to absorb the vitamin decreases with age, so it's important to take a supplement. Why not take a look at our range of vitamin D supplements.

Vitamin B

If you're experiencing stress, panic attacks, anxiety or depression, then B vitamins can be very supportive. Known as the 'stress nutrients', B vitamins help to support your nervous system, the production of your feel-good neurotransmitter serotonin, and help your adrenal glands to manage stress.

As the B vitamins work in harmony, it's best to choose a B complex that provides a range of B vitamins from B1 to B6, plus B12 and folic acid. Food sources of B vitamins include green leafy vegetables, meat, fish, eggs, dairy and fortified foods.

Prescribed medicines

If you can't take HRT or may not want to, some prescribed medications can be used as another option for HRT. Speak to your GP for more information but these may include:

• Antidepressants: These can help with low mood symptoms if you have been diagnosed with depression or anxiety or if you've developed this due to menopause.
• Clonidine: This can help to reduce hot flushes and night sweats caused by menopause and it doesn't affect hormone levels.

The best HRT alternatives

While hormone replacement therapy works for some, it may not be the best option for you, and you might be more open to trying an alternative option. From lifestyle changes, herbal medicines and supplements to more alternative practices, the best option is for you to decide. Speak to your GP to find what is the right HRT alternative for you, or you can trial and combine medicine with therapy options.

At Healthspan we have a range of menopause supplements which include a blend of vitamins and minerals and plant estrogens to help you combat the symptoms of menopause without HRT. For more, read our article on The Best Menopause Supplements.