Hormones, herbal support, or nothing at all: how to choose?
What science actually says about the available options, without simplification or militancy
This information is meant to feed your reflection and enrich your dialogue with your naturopath. It does not constitute medical advice. Naturopathy accompanies, guides and supports the terrain: it in no way replaces medical diagnosis and prescription. Any therapeutic decision regarding hormonal or medicinal treatment rests exclusively with a physician.
The story of HRT
Why what we have believed since 2002 has profoundly changed.
The WHI shockwave
In 2002, preliminary results from the Women's Health Initiative suggested that hormone replacement therapy (HRT) raised the risk of breast cancer, heart attack and stroke. Millions of women stopped their treatment overnight. Prescriptions dropped by 80% within months.
For whom, in what form
The form of HRT changes the risk profile. What the guidelines really say.
The right profile
Women in perimenopause or recent menopause (less than ten years) with disabling vasomotor symptoms, sleep disturbances linked to hormonal fluctuations, symptomatic vaginal dryness or high bone risk. Without a personal history of hormone-dependent breast cancer, venous thrombosis, stroke or active cardiovascular disease.
SERMs
Selective oestrogen receptor modulators — a little-known tool for precise indications.
Tissue selectivity
SERMs behave like oestrogens in some tissues and like anti-oestrogens in others. This tissue selectivity makes them useful in specific situations where standard HRT is not suitable.
Herbal support
Three plants with serious clinical data. Real efficacy, but more modest than HRT.
Cimicifuga racemosa
Serotonergic and dopaminergic hypothalamic mechanism — not oestrogenic. 2023 meta-analysis (22 trials, 2,310 women): significant reduction of hot flushes vs placebo. Dose: 40–128 mg/day of standardised extract. Maximum EMA-recommended duration: 6 months. Rare hepatotoxicity reported.
The 5 questions to ask
Five exact phrasings to structure the dialogue with your gynaecologist.
My personal risk profile
"What is my personal risk profile for HRT, taking into account my family history, my blood pressure, my BMI and my history of thrombosis?" The decision must be personalised. A favourable profile can change an initially cautious medical decision.
Exploration
Question 1 / 8What was the main flaw of the 2002 WHI study?
Main sources: Manson JE et al. JAMA 2017 (DOI: 10.1001/jama.2017.11217) · Contreras Garza NY et al. Post Reproductive Health 2025 (DOI: 10.1177/20533691251341713) · Gu Y et al. BMC Women's Health 2024 (DOI: 10.1186/s12905-023-02788-0) · Lucius K. Integrative Cancer Therapies 2024 (DOI: 10.1177/15347354241242355) · Hedaoo K et al. Journal of Mid-life Health 2024 (DOI: 10.4103/jmh.jmh_242_23) · NCCIH. Black Cohosh Fact Sheet 2024.
This exploration is educational. It does not replace individualised medical advice. Terms and conditions →