🌿 Menopause, Hormones & Kidney Health: What You Should Kno w

If you’re navigating menopause alongside chronic kidney disease (CKD) or concerns about blood pressure and heart health, you’re not alone — and you’re not without options. I’ve been deep-diving into the latest research on hormone therapy (HRT) and kidney function, and here’s what I’ve found.

🧬 How Estrogen Affects Kidney Healt h

While many people assume that HRT is off the table if you have kidney issues, the latest evidence suggests otherwise — particularly when it comes to transdermal estrogen (the kind that’s absorbed through the skin via a patch or gel).

Estrogen plays a surprising number of roles in supporting vascular and kidney health. Some of its key benefits include:

🩸 Stimulating nitric oxide (NO): This helps dilate blood vessels and improve blood flow — good for the heart and kidneys

💧 Inhibiting the RAAS system: This system is involved in blood pressure regulation. Estrogen helps lower BP and supports kidney perfusion

🛡️ Reducing arterial stiffness and atheroma (plaque) formation

🔥 Reducing inflammation: Estrogen’s anti-inflammatory effects may help slow the decline of kidney function

📊 What Does the Research Say?

A 2024 study following over 760,000 women found that postmenopausal HRT was associated with:

• Lower risk of progressing to kidney failure
• Fewer cardiovascular events
• Lower overall mortality

And importantly, transdermal estradiol does not increase the risk of blood clots, even in people with CKD or a transplant history (Vinogradova et al., BMJ 2019).

💊 Oral vs. Transdermal Estrogen: Why the Difference Matters

Some older studies have shown that oral estrogen may actually worsen kidney function in postmenopausal women. This is one of the reasons we strongly prefer transdermal routes, especially when kidney or heart health is part of the picture.

🌸 Menopause, CKD, and Quality of Life

CKD — like many chronic illnesses — doesn’t just affect the lab results. It affects how people feel every day. Fatigue, brain fog, poor sleep, and mood changes are common in both menopause and CKD. And for some, carefully prescribed estrogen can make a real difference in overall wellbeing.

👩‍⚕️ So, Is HRT Safe with Kidney Disease?

Yes — in carefully selected women, hormone therapy can be part of a holistic and safe treatment plan. The key is:

• Using transdermal estrogen
• Pairing it with a non-androgenic progestogen (like micronised progesterone/Utrogestan)
• Individualising treatment based on symptoms, labs, and overall health
• This is not one-size-fits-all care — it’s personalised medicine that takes your whole story into account.