Dr. Tabatha Barber explains that hormone replacement therapy works throughout the body, affecting bones, cardiovascular health, brain function, and more. When you stop HRT, she says, you enter "hormone poverty": arteries stiffen, blood pressure rises, bones weaken, and dementia risk may increase. Unlike old guidelines suggesting five to seven years, HRT is typically lifelong for those who want to keep its benefits.
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How long do I stay on hormone replacement therapy? That's a great question. As long as you want to feel good and slow down the aging process. Hi, I'm Dr. Tabatha, the Gutsy Gynecologist. I'm a triple board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for For thousands of women, I've come to realize that your gut health determines your gyn health and your overall health. And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more Band-Aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your Gutsy Gynecologist. So welcome. Welcome back. Oh my goodness, I love answering questions. I could do this all day. So thank you for all of your questions. This is one I keep getting, so I definitely wanted to talk about it. How long do I stay on hormone replacement therapy? That's a great question. As long as you want to feel good and slow down the aging process. That is the short answer. That is the truth. Here's what happens when you take hormone replacement therapy. Hopefully you're taking bioidentical hormone replacement therapy. But while you're taking that, using it either as a cream, as a patch, as a pill, As a gel, as a troche, as a pellet, however you're receiving it, you're receiving the benefits of that in your body. Your body is feeling the effects of those hormones. Those hormones are able to bind to your receptors all throughout your body and stimulate a response. We have receptors actually in our GI tract to estrogen, progesterone. We have, and testosterone, we have them in our skin, in our brain, in our bones, in our cardiovascular system. Our immune system responds to these hormones. Like all the systems play an integral role in response to our hormone levels. So if you stop taking your hormone replacement therapy, you will stop getting the signals from those hormones because they— those receptors will no longer be stimulated. There's no hormones to send a response, so you will no longer receive the benefits of the hormones. We know the evidence is clear that once you are in a hormone deprivation state chronically— my, my good friend Dr. Kieran Dunstan calls this hormone poverty. Once you are in hormone poverty, you are back in the menopausal state. You no longer receive the benefits from those hormones, so everything shifts. All the systems, they shift how they're functioning because your hormones or the hormones that you're taking have an effect on how the system functions. So, for example, when the cardiovascular system no longer has the protection of estrogen, Things shift. In particular, the arteries become stiffer. They no longer are elastic and pliable to be able to squeeze and move and pump our, you know, blood out to our brain and our extremities and our kidneys and everywhere throughout our body. So we have to increase our blood pressure. We have to pump it harder. out of our heart because our arteries are stiff and it's harder to get the blood through to all the places it needs to go. Sometimes those arteries, like, they spasm down, they clamp down, they become smaller, so less blood can even get through them, and we can start to see less blood flow to major areas of our body. The biggest place that we usually notice it is our vagina and our pelvis. So our vaginal health is affected, our bladder health is affected, the supportive structures in our pelvic floor are affected. And it starts out like it's, it's not a big deal. There's some changes. You might notice your blood pressure is up a little bit. Your cholesterol levels start to go up a little bit. You're starting to notice some vaginal dryness. You're not as lubricated with intercourse, but it's all manageable. It's all doable. But as the years progress and continue on, these symptoms, these problems accumulate. They multiply over time. So the problems get worse, not better. The vaginal dryness worsens to the point where many women just stop being physically sexually active because it's so uncomfortable. And, you know, over-the-counter lubricants are not enough. It's too painful. Or you start having bladder leakage and you can no longer control your bladder, and then you have to go on medications to stop that. But the fix is actually getting the estrogen back. So The bones start to thin. Our bones are very active; they're metabolically active. We're constantly building new bone and breaking down old bone, and you want to have a nice balance of breakdown and growth. And when you don't have estrogen, you get out of balance, and you have more breakdown than you have building. And so you get into this space of bone thinning, osteopenia, and eventually osteoporosis because it's a cumulative effect over. Time. The same thing with the neurons in your brain. You start to lose that neuroplasticity and that production of new neurons, and you eventually increase your chances of developing dementia or Alzheimer's. So just understand that if you're signing up for hormone replacement therapy, you are probably signing up for lifelong hormone replacement therapy, or as long as you want the benefits to be there. So I hope that helps. I hope that makes sense. The old dogma of only be on it for 5 years or 7 years, then you got to go off of it— that turns out that is not true. That is not helpful for women. That is not beneficial for women. There is no science backing that data. There are millions of women over the age of 65 and 70 that are still on hormone replacement therapy, and they are some of the healthiest women in their age group. And so don't be fed the lie that you have to go off them after a certain amount of time. That is just not true. Okay? So I hope that was helpful for you. Keep sending me your questions. I'll see you soon. Bye.
