The biggest decision we face in Menopause: HRT or Natural medicine? It doesn’t have to be one or the other.

 

When people search for menopause support, they’re often met with polarising messages.

I can’t lie, I think about menopause all the time. One because I work with mainly women and gender diverse people who are going through perimenopause or are in menopause and two I am someone who wants to be prepared and know my options. Which is why I have noticed the dilemma. One path emphasizes Hormone Replacement Therapy (HRT) as the best approach, another promotes natural or holistic approaches as the safer or more aligned option.

This can leave you feeling like you have to choose a camp.

But in practice, menopause care is rarely that simple and it doesn’t have to be one or the other.

As a naturopath, I work with many people navigating perimenopause and menopause who are:

  • Already using HRT

  • Considering HRT

  • Choosing not to use HRT

  • Or moving between approaches over time

What matters most is not ideology, but how your individual body responds and what best supports your quality of life.

Understanding the Difference Between HRT and Natural Medicine

Both HRT and natural medicine can play an important role in menopause support — but they work in different ways.

Hormone Replacement Therapy (HRT)

HRT involves replacing or supplementing hormones such as estrogen, progesterone, or testosterone as levels fluctuate or decline.

For some people, HRT can be life‑changing, particularly for symptoms such as:

  • Hot flashes and night sweats

  • Severe sleep disruption

  • Vaginal dryness or discomfort

  • Rapid mood changes or anxiety

  • Bone density concerns

  • Cognitive disturbance such as impaired memory or brain fog.

Natural Medicine for Menopause

Natural medicine focuses on supporting the body’s regulatory systems, rather than replacing hormones directly.

This may include:

  • Nutrition and blood sugar support

  • Herbal medicine that mimic estrogens called phytoestrogens.

  • Nervous system regulation

  • Stress and sleep support

  • Gut and liver health

  • Addressing inflammation and nutrient depletion

Rather than forcing the body in a particular direction, natural approaches aim to help the body adapt more smoothly to hormonal change.

Can You Use HRT and Natural Medicine Together?

Yes and many people do best with a combined, integrative approach.

For example, someone may:

  • Use HRT to reduce severe menopausal symptoms

  • Use natural medicine to support sleep, digestion, mood, and energy

  • Use functional testing to check hormonal pathways

  • Improve how hormones are metabolised through liver and gut support

  • Regulate stress physiology and the nervous system, which strongly influences hormone signalling

In this context, natural medicine doesn’t compete with HRT it supports the foundations that allow HRT to work more effectively.

This integrative approach can sometimes:

  • Improve tolerance to HRT

  • Reduce unwanted side effects

  • Support long‑term wellbeing beyond symptom relief

What If One Approach Doesn’t Work for You?

This is an important and often overlooked part of menopause care. We all have a unique path for how we came to menopause therefore our bodies will all react differently to the treatment option we choose.

The first approach we choose might not work.

Some people try HRT and find that:

  • Symptoms don’t improve as expected

  • Side effects outweigh the benefits

  • They don’t feel like themselves

Others commit fully to natural menopause support and still experience:

  • Ongoing hot flashes

  • Persistent insomnia

  • Mood changes that don’t resolve despite excellent self‑care

This doesn’t mean you’ve failed.

It simply means your body may need a different lever pulled.

If natural approaches haven’t been enough, HRT may provide necessary relief. If HRT hasn’t felt right, deeper support around stress physiology, nervous system regulation, blood sugar balance, or nutrient status may be essential.

Personalised Menopause Support

Menopause is not a single event, and there is no one‑size‑fits‑all solution. The road map is different for all of us.

Whether you choose HRT, natural medicine, or a combination of both, the goal is the same:

To feel well, supported, and at home in your body.

You are allowed to change your approach. You are allowed to use more than one tool. You are allowed to prioritise quality of life.

If you’re looking for personalised menopause support that integrates natural medicine with a clear understanding of medical options, working with a practitioner who respects both approaches can make all the difference. Book a free call to see what approach may be best for you.

 
 
 
Female Health, Womens Health, Naturopath Auckland, Naturopath, Inflammation, Fatigue, Energy, Mental Health, menopauseKatherine MatthewsNaturopath Auckland, MenopauseComment