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Client Story: Beyond Hormone Replacement Therapy (HRT)

Written by Meghan Rhodes MCPP MAPA

When L had her first consultation with me, I asked her the same first question I ask every new client - 'So, what prompted you to book in?'

She had been referred by a friend who had very kindly suggested L see her 'herb lady', so she scheduled a consultation. She had some anxiety and felt her brain was a bit foggy, but was otherwise unsure. I explained that wasn't a problem and that we'd go through each system of the body - both current state and history - and then we could discuss her priorities for support.

When we got to discussing her reproductive health, she mentioned she'd had really intense hot flushes and perimenopausal anxiety. Her doctor had offered Hormone Replacement Therapy (HRT). She wasn't particularly keen on it, but the hot flushes were unbearable, so she went for it.

I made a note, and when we completed our tour of the body and were exploring her priorities, I said, 'I'm just curious because of the way you spoke about it - did you want to come off the HRT?'

'Can I do that?' she asked.

'Of course,' I replied. I explained what the process would look like - very gradually decreasing her HRT dose whilst slowly adjusting a bespoke herbal remedy that would support her hormones as they navigated a transition period until they reached a new balance ratio.

I also shared with her information her GP hadn't - how HRT is designed to synthetically hold the balance of your hormones (namely oestrogen vis-à-vis progesterone) at the fertile/menstruating ratio, which interrupts and confuses the messages the body needs to communicate to itself, whilst giving your liver (which not only digests and processes food, but also hormones and any chemicals that may be put into the body) additional work processing unnatural substances. Think of it as a ship in stormy seas. Instead of having a skilled captain at the helm, the ship is set on auto-pilot with a final destination entered, but it won't be taking into account any nuances in the changes in weather or other conditions at sea.

This design also means there can be withdrawal symptoms worse than the original complaints when you come off HRT - just like someone who has become addicted to high-strength medications for headaches can get worse headaches when they stop taking the medication or someone using a steroid cream for eczema has a backlash of painful, dry itchy skin when they stop using it. This is because the medication has been masking the symptoms of what's going on the body (silencing the messages), rather than addressing the root cause and supporting the body in getting into balance. So to go back to our ship analogy, you're then left with the ship taken off auto-pilot in the middle of a storm at sea with an inexperienced sailor struggling to steer the vessel.

Neither of these situations is ideal and neither were explained to L by her regular healthcare provider.

a cup of fresh sage tea

L decided to go for it. She preferred using natural remedies to support her health and didn't like being on the HRT to begin with. We worked very gradually putting a herbal 'captain' at the helm who could navigate alongside the auto-pilot settings under her body was ready for the captain to take full responsibility for navigating her through the seas of the menopause.

Before decreasing her HRT dose, I first introduced a bespoke tincture blend that supported her hormone levels, as well as the integrity of her gut, alongside a bespoke herb infused vinegar to bolster her liver in processing nutrients and hormones. After three months, she reduced her tablet from 3/4 of a pill to 1/2 - a very small decrease, whilst I made further gentle adjustments to her personalised tincture. Sometimes it was another three months before we'd make an adjustment to her dosage and herbal blend; other times, it was a longer period. The important thing was to go at the pace of her body - not any prescribed schedule set out by a textbook of averages. The key was for both of us to listen and then respond and support.

Working at L's rhythm, after 18 months, L was able to come off her HRT completely with no resurgence of menopausal symptoms and no HRT withdrawal symptoms. We now check in less frequently - every few months - to discuss if any adjustments need to be made to her bespoke herbal remedies. And ultimately, we'll slowly decrease the use of her herbal tincture, as well, until the only support she needs is as and when something crops up in the normal ebb and flow of life she'd like support with.

The goal is not for her to need her herbal remedies forever; rather, it is to allow her body's innate captain to assemble the finest crew, which together, can navigate anything the seas of life send their way.

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