Raena Morgan: Hormone replacement therapy is a controversial treatment. Exactly what is it? Dr. Molly Ferguson: So, when women go through the transition from cycling—having a regular menstrual cycle—to not cycling anymore, their ovaries actually stop producing, for the most part, their estrogens and progesterones—sex hormones. And production of those hormones actually transitions primarily to their adrenal glands. So these are the two little glands that sit on top of our kidneys, approximately right here, under your rib cage. And— Raena Morgan: So we still get estrogen? Dr. Molly Ferguson: So you still get estrogens and you still get progesterones, but to a much lesser extent. For some women, it’s a much lesser extent than others. And so, hormone replacement therapy replaces those hormones that aren’t being produced in as great a quantity from their ovaries as prior to menopause. So, it usually involves supplementation of progesterones and estrogens, sometimes just one or the other—sometimes different forms of estrogens, sometimes testosterone as well. But that generally is what hormone replacement therapy is. Raena Morgan: But it became controversial because the Women’s Health Initiative found that it caused heart disease and breast cancer in some of the people who participated in the study. Dr. Molly Ferguson: That’s correct. And so, it’s become a much less used therapy, actually, since that initiative came out—simply for the risk of breast cancer. Adequate hormone levels are necessary for healthy—our mental health, for the way we feel, for muscle maintenance and for actually bone, as well. Those are some of the reasons why hormone replacement therapy is still used for treatment of osteoporosis and prevention of osteoporosis. Raena Morgan: What are some natural treatments? Dr. Molly Ferguson: Some of the more natural treatments that I certainly deal with quite a bit are use of bioidentical hormones and—so this is similar to hormone replacement therapy. I’d say it is a form of hormone replacement therapy. But rather than using chemical estrogens and progesterones that are based, actually, off of horse hormones— Raena Morgan: That’s right. Dr. Molly Ferguson: These are actually identical—chemically identical—to the estrogens and progesterones that your body produces. So typically, women will have much fewer side effects on these bioidentical hormones in comparison with the more widely available hormone replacement therapy. So, decreased side effects are a big reason people would choose to use those. Other things that certainly play into that hormonal shift health and making that transition smoother and decreasing your risk for osteoporosis, as well as increasing your body’s actual hormone production would include diet and lifestyle factors and the use of herbs. There are many herbs that can actually be used that have—they’re called phytoestrogens—meaning plant estrogens. They’re not technically estrogens, but they act as estrogen receptors and can help with symptoms of hot flashes, vaginal dryness, other complaints that women often have with menopause. And so oftentimes, that’s a starting point—is, first of all, looking at what their hormone levels are. And if they need some sort of supplementation, starting off with phytoestrogens and other herbs that can help reset your body’s hormone production. Raena Morgan: And then you would go to the bioidentical? Dr. Molly Ferguson: And then if they’re still needing something more—we’re not able to raise estrogen levels enough or progesterone—then looking at bioidentical hormone use, too. Raena Morgan: And does that require a prescription? Dr. Molly Ferguson: Not always. There are some over-the-counter creams and other things like that, that actually do contain bioidentical hormones and estrogens. But there are certainly higher dose bioidentical hormones available as well. Raena Morgan: But that’s a lot safer? Dr. Molly Ferguson: Yes, yes. Your body actually recognizes those hormon