What Supplements Can I Take With HRT?

Millions of women in the UK opt for hormonal replacement therapy (HRT) to avoid or manage the uncomfortable symptoms associated with menopause and perimenopause. According to NHS, HRT is beneficial for the purpose, and most women have experienced benefits.
However, just like other treatments, HRT is not free from side effects; among them are the effects on the absorption and metabolism of essential nutrients like calcium, magnesium, iron, and vitamin D.

Nutritional imbalances cause various health effects. Understanding the dietary disturbances and opting for desired supplements is best for a smooth elderly life. Besides handling the undesirable effects of HRT, some supplements offer additional benefits and boost overall health.

The article discusses some essential vitamin supplements with HRT for guidance. For a more detailed overview of the pros and cons of HRT, click here. 

Best supplements with HRT

This article explains all the nutrients influenced by contraceptive pills and HRT and when the supplementation is needed. However, the decision to go for supplements must be taken in consultation with the dietician or a healthcare provider.

Vitamin D and calcium

The restoration of oestrogen levels due to HRT stabilises the bone density parameters. Still, calcium and vitamin D supplementation sometimes becomes necessary to ensure that the body receives enough of them, particularly in people with low serum levels. A group of researchers in the USA found that oestrogen therapy causes low serum calcium and phosphorus and high levels of vitamin D metabolites. 

A good practice is to regularly check the levels of total calcium, ionised calcium and 25-hydroxyvitamin D (25(OH)D) and go for supplementation in case of low levels. The article discusses some essential vitamin supplements with HRT for guidance.

 

Omega 3 fatty acids

Omega 3 fatty acids found in seafood and fish liver oil are essential for cardiovascular health and have anti-inflammatory effects. In postmenopausal women, the risk of heart disease increases changes in lipid profile, redistribution of body fat, weight gain, lower levels of physical activity, and a higher risk of hypertension, and omega-three fatty acid supplementation helps reduce the risk.

NIH Office of Dietary Supplements recommends a supplement providing at least 0.5-0.9g of omega 3s in children and 1-1.6g in adults.

Magnesium  

Magnesium improves overall wellness by boosting muscle functions and brain and bone health. Mg deficiency is responsible for various neuronal disorders in the postmenopausal phase, like mood swings and insomnia. Lower intracellular levels of Mg2+ cause neuroinflammation, and dietary Mg supplementation is a novel approach to treat it, says Professor Jun Zhang (Zhongshan School of Medicine, China)

A recommendation is to use supplements providing 300-400mg of Mg daily.

 

B Vitamins 

Some vitamins in the B family, particularly folate, B12 and B6, regulate nervous functions, energy metabolism and mood regulation. The symptoms experienced by postmenopausal women, e.g., cognitive changes, fatigue and mood swings, are alleviated by vitamin B supplementation.

These are water-soluble vitamins, and there are no issues in extra doses. However, dosages must be discussed with a nutritionist.

Black Cohosh 

It is an herbal product obtained from a plant in the buttercup family, native to North America. It has shown effectiveness in alleviating some signs of menopause, e.g., night sweats and hot flashes. The supplements prepared from the rhizomes and roots of the plant are available in the form of liquid extract, dry extract and whole herbs.

The scientific evidence supporting its use is lacking, and in fact, the North American Menopause Society advises clinicians to avoid recommending it as it is ineffective. It is contraindicated for individuals having liver damage. 

Probiotics 

Hormonal fluctuations associated with menopause and HRT disturb gut health, causing signs like diarrhoea, bloating and constipation. Beneficial bacteria in probiotic supplements, such as Lactobacillus species, Bifidobacterium species, and Saccharomyces boulardii, help restore gut health and help manage gastrointestinal discomfort. 

Incorporation of probiotic foods (e.g., yoghurt, cheese tempeh and kefir) and supplements in the daily routine is an adequate safeguard for digestive health and wellness.

 

Soy isoflavones 

These are the phytoestrogens found in soy products and soybeans and are investigated for their benefits in alleviating the symptoms of menopause. According to Professor Mark Messina (The American Journal of Clinical Nutrition), isoflavone supplements containing genistein (soybean isoflavone) effectively treat hot flashes in menopausal women.

However, the supporting evidence is anecdotal; scientific evidence is limited and must be used cautiously.

 

Evening primrose oil 

It is obtained from Evening primrose, a plant native to North and South America. It is an excellent source of omega-6 fatty acid and gamma-linolenic acid (GLA), which have anti-inflammatory properties. Some women use it to alleviate symptoms of menopause and postmenopausal syndrome (PMS), e.g., mood swings and breast tenderness. 

The benefits are individual, and research-based evidence is limited. Some side effects, e.g., abdominal pain and nausea, are additional nuisance. 

People also ask

Which vitamin deficiencies are experienced during HRT? 

Oestrogen supplements cause a disturbance in the metabolism of various nutrients, particularly zinc, vitamin B6 and magnesium. The depletion of these nutrients causes multiple side effects. 

How is HRT beneficial? 

The HRT helps manage various signs of menopause and perimenopause phase, e.g., sleep disturbances, night sweats, hot flashes, low mood, anxiety and vaginal dryness. 

Are vitamins safe during HRT? 

It is perfectly safe to take vitamin supplements, particularly vitamin D, magnesium, calcium and zinc. It is necessary to stick to the dosing guidelines. 

For how many years must HRT be continued? 

There are no strict guidelines. However, health professionals recommend continuing HRT as soon as the benefits outweigh the costs and risks.

Is exercise good during HRT? 

Yes, it is a good habit to spend some time on exercise during HRT as it complements the effects of HRT. It improves the body's ability to fight diseases and improve overall well being.

Conclusion  

HRT is beneficial for individuals experiencing symptoms of hormonal imbalances in the postmenopausal phase. The inclusion of some dietary supplements in the diet is beneficial for overall wellbeing and health. For example, vitamin D and calcium boost bone health, omega-3 fatty acids improve cardiovascular health, and probiotics, B vitamins, Cohosh black, evening primrose oil, and soy isoflavones are valuable supplements to complement an HRT regime.

The individual's needs vary from person to person, and the choice and dosages depend upon many medical and individual factors. Consultation with a nutritionist and healthcare provider is necessary. Click here to consult Welzo Health Professionals and view our menopause-related tests and products.