Menopausal Hormone Therapy
Dr. Rebecka Hoppins, ND
Sex and the older woman used to be considered an oxymoron, rarely mentioned in the same breath. Finally, menopause is having big media moments, including a just-published book, Dare I Say It – Everything I Wish I’d Known About Menopause, by Naomi Watts.
Nearly thirty years ago, I was fortunate to be in the right place at the right time. I was living in Honolulu and hosted a radio show “Fifty-Plus and Fabulous – A Show About Successful Aging.” One of my guests was a medical doctor specializing in longevity. As I was then just beginning menopause, he suggested bioidentical hormone replacement therapy (BHRT), which included regular doses of estradiol (Bi-Est), progesterone, and testosterone. As a result, I’ve enjoyed “postmenopausal zest” for all these years! Going from fertile to menopausal, I was closed for business—but open for pleasure!
My guest, Dr. Rebecka Hoppins, is a board-certified naturopathic physician and a 2005 graduate of Bastyr University near Seattle. She has 20 years of clinical experience with a particular focus on hormone balancing. She is deeply passionate about educating her patients regarding the effects of hormone dynamics in our day-to-day activities and the impact they have on every aspect of our lives: relationships, work, mental health, home life, and bigger health issues. You can reach her at the Sage Integrative Medical Clinic – www.sagemedclinic.com .
Dr. Becky shared her personal perimenopausal management. She reports, “I come from a history of women with significant PMS and menopausal symptoms. Since I’ve been practicing hormone balancing in clinic for 20 years, I don’t get symptoms as long as I follow my own rules!”
She and I had an informed conversation debunking these three common myths about menopause:
- MYTH. Estrogen replacement therapy causes breast cancer.
TRUTH. Estrogen replacement therapy does not increase your risk of breast cancer over your preexisting baseline risk. The WHI study (2002), the source of this myth, has been reevaluated. - MYTH. The deterioration of vaginal tissues that can happen with menopause will resolve over time.
TRUTH. The genitourinary syndrome of menopause (GSM) includes dryness, itching, painful sex, urinary incontinence, and frequent UTIs, and will worsen over time if not treated. Systemic hormone therapy—especially topical local estrogen which can be used vaginally—typically prevents GSM. - MYTH. I can’t take hormone therapy because of the dangers of blood clots.
TRUTH. The risk is less than the risk that exists from taking oral birth control. Hormone therapy very likely safe when administered via transdermal patch.
And, of course, many menopausal women find that their sex drive diminishes or disappears. What can you do to enjoy sex more? Dr. Becky suggests topical estrogen, adrenal balancing, managing stress—and picking the right partner. Both of us agree that nothing is going to be helpful if you don’t like your partner! We also discussed how estrogen helps with orgasm, and how a vibrator can become an important aid to enhancing a woman’s capacity to achieve orgasm. The more a woman practices on her own and teaches her partner what she likes, the easier it is for her to reach climax.
Dr. Becky is a delight and so well informed. Please listen! You will learn a lot!
Click below to listen to the interview (approx. one hour):
