Doctors once thought hormone replacement therapy (HRT) improved women’s health after menopause, but in 2002 dramatic health evidence to the contrary halted the Women’s Health Initiative HRT study while it was still under way. Hormone therapy did provide some bone density and colon cancer protection but also increased the risks of heart disease, blood clots, stroke and breast cancer. Bioidentical hormone replacement therapy (BHRT), which uses estrogen and progesterone products made from plant hormones said to be identical to women’s hormones, have since become popular. Dr. Susan Love recommends that women use BHRT with the same caution as HRT—and never longer than five years.
Quit cold turkey. There is no health danger in doing so. About half of women using hormones can quit with no tapering off—and with no ill effects or any return of bothersome menopausal symptoms—and you may be in that lucky percentage. If not, or if you’d rather not find out, proceed to step two and to “Weaning Steps” below.
Taper hormone use gradually, using one of several alternative approaches put forth by Love and described under “Weaning Steps”--general strategies that work for BHRT as well as regular HRT.
Start taking 1,000mg of calcium daily when you begin to taper off, to support bone health.
Begin taking a calcium with vitamin D supplement daily (1,200mg calcium with 400 to 800 IU vitamin D) as soon as you’re completely weaned from hormones.
Prepare for tapering off your BHRT by taking regular doses on weekdays (Monday through Friday) but none on weekends. Continuing this for two to three months. Then either try to quit cold turkey or continue to step two.
Steadily decrease your BHRT dosage. Alternate between regular and half-doses each day for three to six months. Then add an extra half-dose day on occasion—and sometimes another, for several straight half-dose days—and continue this for three months. Then drop to a half-dose regularly for the next three months. Either quit outright at that point or go to step three.
Cut your BHRT dose in half again—taking a half-dose every other day, for example—for another three months. Then either halve your dose again or quit outright.
Rather than changing your compounding prescription several times to lower BHRT doses—each prescription costs about the same, no matter the dose—save money by staying with your original prescription but steadily using less.