Menopause and Hormone Replacement Therapy

Shilpa P. Saxena, MD

Shilpa P. Saxena, MD

IFM’s recent practitioner survey revealed an overwhelming majority of patients who visit Functional Medicine clinicians are women. With over 10 years of running a Functional Medicine practice, I can firmly state that perimenopausal and postmenopausal women are likely one of the largest demographic groups within my practice and most FM practices. Why?

Most other approaches do not address the two main hormonal goals for today’s women:

  1. Improving symptoms by addressing why each woman is uniquely imbalanced;
  2. Reducing risks with the safest options available.

The typical hormone replacement therapy (HRT) medical appointment aims to blunt symptoms and views women as a three-zone problem: bikini, breast, and brain. The goal: prescribe the lowest effective dose of HRT for the shortest amount of time in order to reduce cancer and/or stroke risks. This strategy fails to address one major problem: the underlying cause of the hormonal imbalance symptoms. Women are vastly different from each other, both biochemically and genetically, and their unique life stories play a major role in the underlying causes of their symptoms.

At the Hormone Advanced Practice Module, you will gain a greater appreciation for the most prevalent factors that contribute to both the annoying and the life-threatening set of symptoms so many women face. Throughout the course, IFM educators will detail the steroidogenic pathways for hormone production and metabolism, examine the evidence for the use of bioidentical hormone replacement therapy, and elucidate the other systems that commonly interplay with hormone health. This powerful way of thinking empowers clinicians to offer real, personalized treatment recommendations on Monday morning to their current patients and to the growing group of women who seek the same services from a Functional Medicine practitioner.

The Women’s Health Initiative, a major government-funded study, linked hormone replacement therapy with a number of health problems. It was later determined that the recommendations were inappropriate for younger women who took hormone replacement therapy for symptomatic menopause because most of the women studied were well past their early menopause symptoms. The truth is, we can no longer treat the statistical woman—she doesn’t exist.

Helping women optimize the benefits of healthy hormones through the Functional Medicine model will be a vital step forward for women’s health.


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