Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT) refers to exogenous administration of estrogen, progesterone, or both, to supplement or replace hormonal production the body is no longer sustaining at adequate levels. Testosterone may also be included. HRT is used primarily for menopausal symptoms and for premature ovarian insufficiency (POI), a condition in which ovarian function declines before age 40.
RRM draws a clear distinction between two uses of exogenous hormones. The first: replacing what the body genuinely cannot produce. A 32-year-old with POI who has no functional ovarian estrogen production needs physiological replacement. That is restorative medicine. Without it, she faces accelerated bone loss, cardiovascular risk, and neurological effects. The second use: administering hormones to suppress or override normal reproductive function. RRM does not operate in the second category.
When HRT is medically indicated, RRM clinicians generally favor bioidentical hormone formulations. Bioidentical hormones are structurally identical to the hormones the body produces. Synthetic formulations are not. The evidence comparing bioidentical and synthetic preparations continues to develop, and the difference matters for receptor binding, metabolism, and long-term safety profile.
Patients with POI benefit from early, thorough evaluation before beginning HRT, including discussion of fertility implications. Evidence-based guidelines recommend HRT in POI until at least the average age of natural menopause, given the documented risks of untreated estrogen deficiency.73
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This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.