Understanding Menopause and Hormone Therapy: What You Need to Know

Menopause is a natural part of life, but that doesn’t mean it’s always easy. For many people, the changes in hormones during the transition can bring noticeable symptoms that impact day-to-day life.

Let’s break down what menopause is, what therapies are available, and what terms like bioidentical,
hormone replacement therapy, HRT/BHRT, “natural,” and plant-based really mean.

What is Menopause?

Menopause is diagnosed after someone has gone 12 consecutive months without a menstrual period. In Canada, the average age for natural menopause is around 51.

In the time approaching menopause, the ovaries slow down and eventually stop releasing eggs. This decrease in ovarian function leads to lower estrogen levels, which can cause many of the classic symptoms women experience during this transition.

This stage isn’t just one moment in time, it has three phases:

● Perimenopause: This is the “transition” period leading up to menopause. It lasts 4–8 years, sometimes even starting 10 years before menopause. Periods may become irregular, and early symptoms like heavy periods, worsened PMS, sleep changes, or mood shifts can appear.

● Menopause: Officially, menopause is reached after 12 months without a period. Symptoms may continue or even intensify during this stage. Common symptoms that tend to come closer to or around the menopause date include hot flashes and vaginal dryness.

● Postmenopause: The years after menopause, when periods have stopped entirely. Long-term health considerations, such as bone health, become more important in this phase.

Common Symptoms of Peri- and Menopause

Some people breeze through menopause with minimal symptoms, but many experience a range of
changes.

The most common include:

● Vasomotor symptoms (VMS): Hot flashes and night sweats. These sudden waves of heat can be accompanied by palpitations or anxiety. Over 75% of people experience VMS, with about 20% rating them as severe enough to disrupt daily life.

● Mood changes: The menopausal transition can trigger depressive or anxiety symptoms. People
with a history of depression, premenstrual syndrome (PMS), or postpartum depression may be
at higher risk.

● Sleep disturbance: Night sweats and hormonal changes can impact sleep quality.

● Genitourinary symptoms:  Vaginal dryness, pain and bladder issues such as recurrent
bladder infections, urgency and incontinence. 

● Other physical changes: Fatigue, joint pain, sexual concerns, reported cognitive changes
often described as brain fog and changes in body fat distribution are common.

Menopause Hormone Therapy (MHT) vs BHRT vs Natural vs Plant-based Hormones

You may have heard terms like HRT, BHRT, or plant-based hormones, but these terms aren’t always
clear, or medically precise.

Let’s break them down.

Why We Say MHT Instead of HRT

Traditionally, hormonal treatments used in menopause were called HRT (hormone replacement therapy).

The problem?

It implies menopause is a disease or hormone deficiency that needs “replacing” to premenopausal levels. That’s not accurate.

Medical experts now prefer the newer term Menopause Hormone Therapy (MHT).

This term:

● Recognizes menopause as a natural life stage rather than a disease.

● Focuses on using hormones therapeutically, to relieve symptoms and reduce long-term health
risks like osteoporosis.

● Distinguishes therapy for menopause from other hormone therapies, such as those used for premature menopause or gender-affirming care.

What About Bioidentical or Natural or Plant-based Hormones?

● Bioidentical hormones (BHRT): This term is often used to refer to hormones with the same
chemical structure as the ones our bodies naturally produce, like estradiol and progesterone.
However, your doctor may not use this term because “bioidentical” doesn’t have a strict medical
definition and it’s not used in the research to describe hormone therapies. Typically in the
research, hormones are described using their technical chemical name, like “estradiol” which is
a very common estrogen used for MHT.

● Plant-based or Natural hormones: These are terms that are often misunderstood. When people hear these phrases, they often imagine hormones that come directly from plants or are
somehow gentler or safer by default.

In reality, estrogen, progesterone, and testosterone used in hormone therapy are not found in usable amounts in plants. Some hormones are derived from plant sources (such as yams or soy) in a laboratory, but they must undergo significant
chemical processing to become active human hormones.

What matters most for safety and effectiveness is the hormone’s final molecular structure, dose, and delivery method — not whether it started in a plant. The term “natural” is a marketing description, not a medical one,
and doesn’t reliably predict safety, risk, or how your body will respond.

Who Is a Good Candidate for MHT?

MHT isn’t for everyone, but it can be life-changing for those struggling with:

● Severe hot flashes or night sweats disrupting daily life
● Vaginal dryness

● Sleep disturbances or fatigue related to menopause

● Mood changes like anxiety, irritability or low mood during the menopause transition

● Increased risk of osteoporosis

Bottom line: Safety in menopause hormone therapy comes from using well-researched, regulated
treatments and choosing the right option together with your practitioner, based on your unique health history and goals.

A healthcare provider like a a Naturopathic Doctor can help assess your personal
risk factors, medical history, and goals to determine whether MHT is appropriate for you.

The goal isn’t to “replace” hormones to premenopausal levels, it’s to support your body, improve quality of life, and protect long-term health.

Final Thoughts

Menopause is a natural life stage, not a disease, but its symptoms can significantly affect daily life.

Menopause Hormone Therapy (MHT) can be a helpful tool for managing symptoms and protecting health.

When working with a menopause-focused practitioner, they will focus on what’s safe, evidence-
based, and tailored to you.

If you’re experiencing bothersome symptoms, a personalized consultation at Natural Choice Medical Clinic in Guelph with our one of our menopause-focused practitioners can help you understand your options and create a plan that
works for you.