I try to be an earthy, crunchy type of person as much as possible. I'm a big believer that less is more. Physicians are sometimes too quick to write that prescription than to find out what's really going on. As a result, I see ladies who come in on multiple medications, some of which are treating the side effects from another medication, and they wonder why they don't feel well.
I'm not saying that all prescriptions are bad - Heaven knows I'm personally grateful for modern pharmacology, but medication side effects are a big deal.
That being said, the times both around menopause and after can be extremely challenging. There is a difference between transitioning through menopause and feeling terrible. Sometimes hormone replacement is the right treatment.
It's important to know that hormone replacement many times won't work or can make you feel worse. There are a lot of alternatives too. It's also not recommended to be on hormones for more than 5 years.
Of course, I have some women who have told me I can pry their hormone replacement from their cold dead fingers. I know women in their 80's who have been happily taking hormone replacement for their entire lives, including my mother, and they will continue to do so. I've told them all the risks and they smile and tell me they just don't care.
Now I will be the first one to make sure there isn't some other medical issue causing your symptoms. I will counsel you on all the bad things that can happen. I will recommend that you be on hormone replacement for the shortest possible time and make a plan to wean slowly off, over years if we need to. I will usually prescribe FDA-approved medications because I believe they're safer and I'm traditional that way.
As much as I know I am trusted as a doctor, I know that it is because I trust my patients as well to look at all the options and decide. It's not my job to take your hormone replacement away against your will.
Sometimes the oath doctors take to "first, do no harm" is taken to mean "do nothing". Patients don't come here for me to do nothing. They come because they need help. That's why I became a doctor in the first place.