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Weaning HRT

John A. Sunyecz, M.D., F.A.C.O.G. MenopauseRx

Since the 2002 release of the Women's Health Initiative (WHI) trial information that concluded long-term, combination hormone replacement therapy (HRT) can increase a woman's risk of breast cancer, heart attacks, stroke and blood clots, numerous women have considered discontinuing their HRT and moving to drug free alternative treatments. In fact, many women are looking to herbal treatments for menopause symptom relief.


Fortunately, many women are finding that their health care providers are receptive to alternative treatments for menopause symptoms as they attempt to discontinue taking HRT. Unfortunately, information regarding how to stop hormone replacement therapy is lacking. Many questions still remain, such as what is the best manner to discontinue HRT: slowly weaning or quitting 'cold turkey'? Can herbal remedies be incorporated into this process to avoid uncomfortable hot flashes and night sweats? If so, which ones?


Remifemin is one of the most popular herbal remedies to relieve menopause and perimenopause symptoms. Made from a highly standardized formulation of black cohosh , it has been shown to reduce hot flashes, night sweats and mood and sl eep disturbances associated with the menopause transition. It's been sold all over the world for well over 40 years. Remifemin is the most studied herbal remedy for menopause symptoms with a long track record of safety.


For the many women who are seeking guidance for these issues, a common sense approach would seem prudent in counseling women during this potentially stressful time.

•  In women using combination HRT and within five years of the menopause, consider sl owly weaning HRT over one month, while incorporating Remifemin . For instance, alternating HRT and Remifemin on an every other day basis for one month. At the end of this month, continuation of Remifemin twice a day on a daily basis could be helpful to avoid uncomfortable symptoms from developing.

•  In women using combination HRT and who are postmenopausal for greater than five years:

  A) An attempt at discontinuing HRT and immediately beginning Remifemin twice daily.

- or -

  B) Stopping HRT and monitor for symptom recurrence. A patient may notice some symptoms within the first two weeks, followed by a gradual reduction in symptoms as her body becomes accustomed to this transition. If symptoms are uncomfortable after four weeks, starting Remifemin would be prudent.


Not all women will be able to discontinue HRT and be symptom free. Women with severe hot flashes and night sweats upon discontinuation may elect to restart HRT. Under the supervision of their physician, consideration of a lower dose HRT or alternative hormonal combination may be discussed as a strategy to restart HRT for these women.

As with all medical decisions, it is recommended to discuss treatment options with your health care provider.

The information provided by MenopauseRx, Inc. is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition.