Dare I Say It: Everything I Wish I'd Known About Menopause

Watts addresses the confusion and controversy surrounding HRT, noting that she will discuss conflicting expert opinions and encouraging readers to conduct their own research. Like many, Watts was fearful of HRT side effects and hesitant to consider it as an option; however, she changed her perspective after learning more.

Watts defines hormones as chemical “messengers” that “tell cells and organs to behave in certain ways” (69), meaning every bodily system is impacted by them. As a period of hormonal transition, menopause is associated with numerous hormone-related issues. During menopause, hormone levels fluctuate, so symptoms may come and go. As of the writing of the text, there is no single test to verify whether a woman is in perimenopause or not.

After briefly describing the hormonal shifts that take place during perimenopause, Watts transitions to a discussion of HRT. Hormone therapy can be delivered in several forms, including local medications, like estrogen creams, and systemic medications, like oral medications that impact the entire body. Some therapies are cyclical, while others are continuous. Women with a uterus are often prescribed both estrogen and progesterone—which lowers the chance of developing endometrial cancer—while those without a uterus take only estrogen.