Exploring the benefits of hormone replacement therapy for menopause

What you’ll learn:

• Hormone replacement therapy (HRT) can reduce menopause symptoms like hot flashes, night sweats, and mood swings.
• HRT might help reduce belly fat by rebalancing hormones that can shift where your fat is stored.
• HRT also supports long-term health by potentially supporting bone strength, improving heart health, and protecting against other diseases, like type 2 diabetes and colon cancer.
• Your clinician will help you find the right HRT to balance the benefits with considerations for safe and effective treatment.

Ever felt an intense wave of heat hit out of nowhere, leaving you flushed and sweaty? These sudden warmth surges—called hot flashes—are common during menopause, with about 75% reporting them as a symptom. But menopause brings more than just heat. It can also lead to disrupted sleep, mood shifts, brain fog, and unexplained weight gain that can disrupt daily life. But there’s good news: Hormone replacement therapy (HRT)—sometimes also referred to as menopause hormone therapy (MHT)—might be able to help. 

HRT restores hormone levels that drop before and after menopause. And it doesn’t just ease symptoms—it can also support bone strength, improve heart health, and protect against other diseases, like type 2 diabetes and colon cancer, as you age. 

Like any treatment, it’s important to understand its benefits and safety considerations to see if it’s the right fit for you. While some studies have raised concerns about the potential long-term effects of HRT, the benefits outweigh the risks in many cases. Everyone’s situation is unique, and you’ll need to consult a medical professional to find the right treatment.

Personalized support can make all the difference. Noom’s unique blend of psychological support and medically-backed insights helps people confidently navigate this transition. 

What happens to your hormones during menopause? 

Menopause marks a significant hormonal shift, impacting nearly every part of the body. These changes happen gradually and are commonly divided into three phases, each with its own challenges and symptoms. Here’s what to expect:

• Perimenopause: This transition period before menopause typically starts in the mid-40s. Decreasing levels of the hormones estrogen and progesterone can cause symptoms like hot flashes, mood swings, weight gain, and increased abdominal fat.
• Menopause: Menopause* is reached when a woman has gone 12 months without a menstrual cycle, signaling the end of eggs being released from the ovaries.
• Postmenopause: After menopause, estrogen levels stay low, and women may face longer-term effects of reduced hormones, like decreased bone density. Symptoms of menopause may ease over time in this stage.

Changes in estrogen levels can trigger various symptoms throughout the body because there are estrogen receptors all over.  While the impact varies for everyone, many people experience:

• Issues with body temperature regulation: Estrogen receptors in the hypothalamus—the brain’s temperature control center—can become less responsive as estrogen levels decline, leading to hot flashes and night sweats.
• Emotional changes: Estrogen receptors in the brain that regulate mood can influence emotional stability. As estrogen decreases, sudden mood shifts and irritability may occur, leaving you feeling off-balance.
• Weight gain: Estrogen plays a role in fat distribution and metabolism. Hormonal shifts can affect receptors in fat tissue, leading to weight gain, especially around the midsection. On average, women might gain about five pounds during menopause. Increased belly fat can elevate the risk of heart disease and type 2 diabetes. 
• Changing sleep patterns: The estrogen receptors in the brain can influence sleep quality. As hormone levels drop, sleep disturbances can become more common, resulting in fatigue and reduced energy levels.
• Weaker bones: Estrogen also helps maintain bone density by regulating the balance between bone breakdown and formation. As estrogen declines, bone loss accelerates, increasing the risk of osteoporosis and fractures, especially in the years immediately following menopause.
• Muscle loss: Estrogen and progesterone support muscle repair and function through receptors in muscle tissue. Their decline can lead to significant muscle loss, reducing strength and metabolic rate.

These systemic effects highlight the importance of addressing hormonal changes holistically during menopause to maintain overall health and well-being.

What is hormone replacement therapy? 

HRT is the term for a variety of hormone-based treatments designed to relieve symptoms of menopause and perimenopause. HRT helps bring hormone levels closer to pre-menopause levels, alleviating symptoms and potentially providing additional health benefits. Most HRT treatments contain estradiol, a hormone that raises estrogen levels. 

Different types of HRT are available, each tailored to individual health needs and situations. It’s essential to weigh the benefits and potential risks, which can vary based on personal health history and the timing of treatment.

How does hormone replacement therapy treat menopause symptoms?

HRT can help restore balance by supplementing the hormones your body produces less of during menopause.

HRT comes in two primary types:

• Estrogen-only HRT: This form is usually prescribed for people who have had their uterus surgically removed (a hysterectomy). 
• Combined HRT: For women who still have a uterus, a blend of estrogen and bioidentical progesterone (also known as micronized progesterone or MP). This bioidentical progesterone is included to lower the risk of endometrial cancer, which can be increased if estrogen is taken alone in someone with a uterus. It also carries fewer risks than synthetic progesterones (progestins), which were previously used in combined HRT treatments.

HRT is typically prescribed in several forms:

• Oral tablets
• Skin patches
• Gels and creams
• Estradiol sprays

The specific HRT regimen—including the type, dosage, and duration—is customized based on age, overall health, and personal concerns. Your healthcare provider will monitor your response to the therapy and adjust as needed to find the lowest effective dose that provides relief.

By replenishing these missing hormones, HRT helps bring your body closer to its pre-menopause state. Here’s a look at some questions about what it can treat: 

Can HRT help me lose weight? 

Hormone replacement therapy is not a weight loss treatment, but it may help address some of the underlying factors that contribute to weight gain during menopause. 

The decline in estrogen levels can lead to changes in fat distribution, increased abdominal fat, and a slower metabolism. HRT can help reduce belly fat. Research has shown that people on HRT tend to have lower body fat percentages compared to those who aren’t using it.

By stabilizing estrogen levels, HRT can also reduce symptoms like fatigue, sleep disturbances, and mood swings, which may help you stick to a balanced diet and regular exercise routine. Let’s face it: who wants to go to the gym when they’re overtired and irritable? Noom’s food color system, recipe catalog, and library of exercises can also help you develop healthy habits that will maximize the benefits of HRT.

Can I take GLP-1 medications for weight loss while using HRT? 

Combining GLP-1 medications with HRT might help you lose more weight. Studies show that people who took HRT along with semaglutide (the active ingredient in Ozempic^® and Wegovy^®) lost more weight than those on HRT alone. HRT helps address hormonal imbalances that often contribute to weight gain during menopause, while GLP-1 medications work to regulate appetite and stabilize blood sugar. Together, they can provide a powerful synergy for managing weight more effectively. 

How do you get started? If you qualify for Noom Med, one of our qualified clinicians can help you decide if adding a GLP-1 medication is the right choice for you. They can prescribe all of the popular medications used for weight loss and then coordinate insurance, if applicable. If cost or accessibility is a factor, they can also prescribe compounded semaglutide* through Noom GLP-1^Rx,  if needed. This exciting option can be cheaper than brand-name medications and is ready to ship if prescribed. It costs just $149 for the first month with personal coaching and support and Noom’s tracking tools, exercise videos, and delicious recipes included.

*Compounded semaglutide available on the Noom platform is produced in an FDA-registered facility but not reviewed by the FDA for safety, efficacy, or quality.

Will HRT work for hot flashes? 

Hot flashes are more than just a passing heat wave in your body. They can be uncomfortable and disruptive, especially at night. HRT can help reduce the frequency and intensity of hot flashes by stabilizing hormone levels, particularly estrogen, which plays a role in regulating body temperature. Various forms of estrogen therapy have been shown to be highly effective in reducing hot flashes. 

The Women’s Health, Osteoporosis, Progestin, Estrogen (HOPE) study found that different doses of estrogen therapy, with or without progestin (progesterone), significantly lowered the number of daily hot flashes. Women in the study went from experiencing around nine hot flashes per day to just two after one year, even on the lowest dose.

The North American Menopause Society also endorses HRT as the most effective option for hot flashes, making it the gold standard for relief.

In addition to HRT, lifestyle changes—like managing weight through diet and exercise—can also ease hot flashes. Studies have shown that weight loss can significantly reduce the frequency of hot flashes. Noom’s personalized weight loss guidance can help you develop healthier habits that might reduce the severity of hot flashes.

Can HRT improve sleep and mood? 

Menopause often disrupts sleep and mood, but HRT may help. In a study of 152 menopausal women in China, those using HRT alongside counseling, diet, and exercise reported better mood and sleep than those relying on conventional treatments alone. The HRT group had a 96% success rate compared to 87% in the other group, with both experiencing mild side effects. Research supports HRT as a practical, safe option for improving sleep and emotional well-being during menopause.

More about HRT and sleep

Menopause often comes with sleep problems, with many women finding it harder to fall asleep or stay asleep due to hormonal changes, hot flashes, and night sweats. Hormone therapy, like estrogen pills or patches, can help improve sleep by balancing these hormones. A study of 653 menopausal women showed that using the estrogen pill or the estrogen skin patch helped women sleep better, fall asleep faster, and feel more satisfied with their sleep than women who didn’t use hormones. The estrogen patch was especially good at reducing sleep disruptions. Researchers also found that when women had fewer hot flashes and night sweats, their sleep quality improved, suggesting that managing these symptoms can help with better rest.

There are many things you can do along with HRT to help improve sleep quality and reduce menopause symptoms:

• Stick to a regular sleep schedule: Setting a consistent bedtime, even on weekends, helps keep your body’s clock steady for better rest.
• Keep your sleep environment cool and comfortable: Keep your bedroom cool, use breathable bedding, and try moisture-wicking pajamas to manage hot flashes and night sweats.
• Avoid eating and drinking before bed: Have your last meal three hours before sleep and stop drinking two hours before to avoid nighttime bathroom trips.
• Practice relaxation techniques: Calming activities like meditation, deep breathing, or a warm bath before bed reduce stress and cortisol, helping you sleep better. 

HRT and mood

HRT can help stabilize mood and improve focus, reducing the “brain fog” and anxiety that often accompany hormonal changes. One study suggests that HRT is most beneficial for cognitive health and mood when started during the perimenopausal or early postmenopausal period. More research on newer HRT formulations is needed to understand their benefits fully.

While HRT can be beneficial, it’s just one part of a comprehensive approach to managing menopause symptoms like mood changes. Try these practical tips to support relaxation and lower stress levels:

• Keep moving: Regular physical activity can improve sleep quality and mood. Try to finish your workout a few hours before bedtime. Yoga is a great way to exercise while also relaxing the body.
• Explore mindfulness: Techniques like meditation or deep breathing can help manage stress and improve your overall emotional state.
• Practice self-care: Managing your time and setting boundaries for self-care can prevent chronic stress.

The Noom app has guided meditations, breathing exercises, and other relaxation tips to help you balance your mood and improve your overall well-being by reducing stress. 

Other benefits of HRT for menopausal health

Hormone replacement therapy provides other health benefits beyond managing hot flashes and mood swings. As estrogen levels drop, women may experience increased risks to bone, muscle, and heart health. HRT helps counter these effects. Here’s a closer look at how HRT can promote overall health and reduce the risk of conditions like osteoporosis, muscle loss, and heart disease, especially when started early in menopause or before age 60:

• Helps prevent osteoporosis: Estrogen is essential for maintaining bone strength. HRT helps preserve bone density, particularly for women who experience early menopause (before age 45). Studies show that HRT significantly reduces the risk of spine, hip, and other fractures, even in people already diagnosed with osteoporosis.
• Supports muscle strength: Menopause can cause muscle loss, making it harder to stay active. Several studies show that HRT using estrogen can benefit muscle health in postmenopausal women. One study found that women using HRT had stronger grip strength and larger muscle size. Another noted that while HRT alone didn’t boost muscle protein, it increased muscle growth significantly after exercise. Overall, these studies suggest that estrogen in HRT works best for muscle health when combined with physical activity. Noom’s Muscle Defense™ library contains exercises and workouts for people of all fitness levels to improve strength and support muscle growth.
• Improves cardiovascular health: Low estrogen levels are linked to increased heart disease risk. HRT can support heart health by promoting healthy blood vessels and cholesterol levels, potentially lowering the risk of heart attacks and strokes. A study found that starting hormone replacement therapy within ten years of menopause or before age 60 significantly reduces all-cause mortality and cardiovascular disease risk in women. While these findings are promising, more studies are needed to confirm the long-term cardiovascular benefits of HRT and determine the safest approach for different groups of women. Remember, Noom can also help provide expert guidance on lifestyle changes, like diet and exercise, to support weight loss that can improve cardiovascular health. 

Safety of hormone replacement therapy for menopause

Many people have questions about the long-term safety of HRT, especially since it’s been linked to an increase in breast cancer. This link originated in a study conducted by the Women’s Health Initiative (WHI), which came out in 2002. News reports that emphasized an increased risk of breast cancer discovered in the study scared a generation of people off of HRT therapy. 

Recent reevaluation of the study has suggested that the actual risk of breast cancer was overstated and not really representative of what the study found. The overall risk was relatively small, but media coverage at the time emphasized alarming outcomes without providing proper context, leading to widespread fear and confusion.

The main issue? The WHI study primarily involved women over 60 who were well past the typical age for starting hormone replacement therapy. This is significant because the timing of HRT initiation can influence its safety and effectiveness. For women who begin HRT earlier, closer to the onset of menopause, the benefits often outweigh the risks, particularly when prescribed appropriately and monitored closely.

Recent studies, like one published in the Canadian Medical Association Journal, provide encouraging findings that HRT can be a safe and effective option for managing menopause symptoms. Again, when started within 10 years of the onset of menopause and before the age of 60. 

The key to using HRT safely is personalization. Your doctor will consider age, health history, and specific needs to tailor the right approach. 

How to get started with HRT for menopause

Thinking about trying hormone replacement therapy for your menopause symptoms? Here’s how to get started:

• Consult a healthcare professional: Discuss your symptoms and whether HRT is the right choice for you. If you use Noom Med, ask your clinician whether adding HRT to your plan could help.
• Know your options: There’s more than one way to use HRT, from pills to patches to gels. Find out which one might work best for your symptoms and daily routine.
• Keep a symptom diary: Jot down your symptoms and keep track of frequency before talking to your provider. HRT can be targeted to exactly what you’re experiencing. 

For those looking to support overall health during menopause, Noom’s personalized approach can complement HRT therapy. We offer guidance on nutrition, exercise, and lifestyle changes to help women feel their best during this transition.

Finding the right balance with HRT

Hormone replacement therapy (HRT) can help manage menopause symptoms like sudden temperature spikes, mood fluctuations, and sleep disruption. But it’s just one part of the equation. Noom offers comprehensive support to help you navigate this phase, combining lifestyle guidance, nutrition, and wellness tools to keep you feeling your best.

To address age-related changes more effectively, you can add Noom’s Healthy Aging and Metabolism Course Enhancement to your plan. This addition to your program will help you through all the ups and downs of managing your weight and health as you get older. It also has a section specifically designed for people going through menopause. It helps you:

• Understand the science behind hormonal shifts and how they impact weight and health.
• Create personalized strategies to match your changing metabolism and body.
• Build lasting habits to maintain a healthy weight as you age.

Whether you’re exploring HRT, focusing on nutrition, or looking for a balanced approach, Noom’s personalized programs can support you every step of the way. See how Noom can help make your menopause journey more manageable.

Note: Ozempic^® is not FDA-approved to treat obesity or for weight loss.