07/27/2026
We Talk About Menopause More Than Ever—So Why Are We Treating It Less?
I recently read a Medscape discussion between two healthcare professionals about the surprising decline in menopausal hormone therapy. Despite everything we now know about menopause, hormone therapy use reportedly dropped to just 1.7% in 2023.
As a woman who struggled with perimenopause symptoms and was strongly discouraged from using hormone therapy by my own OB/GYN, I understand why both women and providers remain apprehensive.
A lot of that fear can be traced back to the Women's Health Initiative (WHI). When the initial hormone therapy findings were published in 2002, concerns about breast cancer, blood clots, cardiovascular disease, and other risks dramatically changed prescribing practices. In fact, hormone therapy use declined substantially afterward.
But medicine continues to evolve.
Today we understand that not all hormone therapy is the same. The specific hormone, route of administration, dose, timing of initiation, age, medical history, and individual risk factors all matter. What may be appropriate for one woman may not be appropriate for another.
Hormone therapy certainly isn't for everyone, and there are women with contraindications or situations where non-hormonal treatments are more appropriate. But fear shouldn't automatically prevent women from having the conversation.
For example, when clinically appropriate, if I have the choice between addressing menopause-related sleep problems with micronized progesterone versus immediately reaching for medications such as clonazepam or Ambien, I want to consider whether the underlying hormonal transition itself can be addressed first.
That doesn't mean hormones are automatically safer than every medication or that every woman needs HRT. It means we should be asking a better question:
What is contributing to this woman's symptoms, and what are the safest and most appropriate options for HER?
Menopause care should be individualized. HRT is one tool. Nutrition, physical activity, sleep, stress management, supplements when appropriate, and evidence-based non-hormonal medications are also options.
Most importantly, women deserve choices and informed conversations, not fear.
I invite you to learn more about HRT and non-hormonal approaches to perimenopause and menopause on my website: https://anironfmip.com/non-hrt-menopause-alternatives-functional-medicine-utah/
Ultimately, the choice is yours. Empower yourself with knowledge, learn to recognize what your body is telling you, and make decisions alongside a knowledgeable healthcare provider. Research continues to evolve, and so should the way we care for women.
Explore non-HRT menopause alternatives in Utah to manage symptoms effectively, without hormone replacement therapy.