Hello teachers, I have a question about estrogen levels as they pertain to women's health in the long-term. Obviously, women spend a good amount of years with "lower" estrogen levels post-menopause; for a woman who enters menopause early, or otherwise has below-average estrogen levels, is HRT necessary? "Protecting the bones" is often cited as the reason to keep estrogen levels circulating in these cases, aside from menstruation. Would a formula like Osteo-Herb be just as good for that function of estrogen (which does much more than protect the bones)? And is there physiological benefit to inducing a monthly (or semi-regular) bleed if ovulation doesn't happen due to low estrogen? Thank you! Jennifer

Wendy said: Well, I'm not sure what you're defining as "early" menopause, but here goes: Average age to be done with periods is 52. Perfectly normal and common to be done by 48. However, anything much younger than 45 is, to me at least, "early". Those women, especially if they are younger than 40, should absolutely be on hormone replacement therapy until the "average age" of menopause. It will help protect bones, but also cognition and cardiovascular status. When I prescribe hrt for these women, I use straight estradiol with progesterone, which is what their bodies would have been producing, had their ovaries not retired early. (for older women, I use a combo of estradiol and estriol). NO reason to make these women cycle, so daily progesterone helps prevent that plus is safer for breast tissue --there is some research that shows cycling progesterone in women who are menopausal actually raises breast cancer incidence whereas daily progesterone in menopausal women is protective. For women of any age, there is increasing research to show that, unless we have an absolute contraindication to HRT, most of us will benefit by at least a few years of HRT even if our symptoms are minimal. This is a very nuanced point and too much to go into here, but something that I discuss with all my patients now. For straight bone health: I recommend Osteoherb as my first choice. One also needs to look at and correct the actual causes of osteoporosis: blood sugar instability (which change the blood pH and therefore causes mineral loss to buffer the pH back to normal), low DHEA from chronic adrenal dysfunction, and gut issues (poor absorption of nutrients). And of course sedentary lifestyles. And no, Osteoherb can't provide the same benefit as estrogens, but it's a really helpful product!

Thank you!

I'm wondering if it's okay to jump in here and ask Wendy - what are absolute contraindications to HRT? Would that be history of estrogen dependent cancer? Anything else?