Thinking Biblically About Hormone Replacement Therapy for Menopause

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I had a question posed to me the other day: How can we think about hormone replacement therapy (HRT) for menopause as Christians?

HRT is a medical treatment that replaces the hormones that decrease during perimenopause and menopause. Like many questions, there isn’t necessarily one right answer for every person. Scripture is clear that we shouldn’t murder or commit adultery. But treating our menopausal symptoms? Not so much. Scripture does give us insight into thinking wisely about our aging bodies, medical treatment, and our motives before God.

At the heart of this question are two main concerns: How we should view getting older and how we should treat the emotional issues that come with menopause.

Is Menopause Part of God’s Design?

The Bible doesn’t clearly state what would have happened if Adam and Eve had never eaten from the tree of knowledge of good and evil. Would they have been forever 21, continuing to have babies throughout eternity? Scripture never says. We do know that they would have continued to walk with God, worked the ground without toil, and not suffered in childbearing. Theologians have speculated on the details, but I don’t think brain fog, hormonal mood swings, and hot flashes were part of pre-fallen humanity. 

Death entered the world through sin (Romans 5:12) and all of creation was affected by the curse (Romans 8:20). Since the physical deterioration that comes with aging is just death in slow motion, it is also a part of the curse. A lot of things happen in our bodies when we age. Our skin loses its elasticity and wrinkles form. Our hair often grays (or falls out). Our blood vessels stiffen, which increases our blood pressure (and therefore our risk of heart attack and stroke). 

Does the Bible Oppose Medical Treatment?

Modern medical research has provided many interventions that can help with these issues. And even though it was written thousands of years ago, the Bible never represents medical treatments as a lack of faith. We see examples of poultices, wine, and oil used to treat the sick (2 Kings 20:7, Luke 10:34, 1 Timothy 5:23, Proverbs 31:6–7). Most guidelines include diet, exercise, and sleep as important components of any medical treatment. But in a lot of cases, medication helps as well. 

Are Menopausal Mood Changes Spiritual or Physical?

Many Christians who are fine with taking high blood pressure medication balk at the idea of using medication to treat emotional or psychological issues. The physical issues associated with menopause, like vaginal dryness and hot flashes, seem straightforward. But other menopausal symptoms are less clear. What about mood swings and brain fog? Isn’t that more of a spiritual issue? Even insomnia can be a window into our spiritual health.

The answer to that will vary between individuals. We are ultimately responsible for our words and attitudes, but our physical condition can certainly make things more difficult. 

Although they are limited, Scripture also has examples of a physical intervention to treat emotional distress. When Elijah was in anguish over Jezebel’s plan to murder him, God sent an angel to tell him to eat and sleep (1 Kings 19:3–9). Physical care was not the entire answer, but it was part of the answer. 

It’s also not always clear where the “physical” ends and the “emotional” begins. Physical pain can be emotionally and spiritually exhausting. Low thyroid can often mimic depression. Supraventricular tachycardia is sometimes misdiagnosed as anxiety.¹

Resting in Grace When the Answer Isn’t Simple

Even after we think through the biblical principles, it’s still hard to know if we are making the right decision for the right reasons. Sometimes in the turmoil, it’s tempting to believe that doing nothing is somehow more godly. I take great comfort in what Paul said in 1 Corinthians:

My conscience is clear, but that does not make me innocent. It is the Lord who judges me. Therefore judge nothing before the appointed time; wait until the Lord comes. He will bring to light what is hidden in darkness and will expose the motives of the heart. At that time each will receive their praise from God. 1 Corinthians 4:4–5

If Paul couldn’t always trust his own motives, the rest of us can’t either.

If we boil the question down to “Will this help me serve God better?” the answer could be “yes.” A healthy diet, exercise, adequate rest allow us to serve him with energy and enthusiasm. Medical interventions can also serve this purpose. Paul longed to be home with the Lord, but also saw the need to do God’s work among the perishing, and sought to stay here working as long as God allowed (Philippians 1:21–26). 

There are some women for whom HRT isn’t best due to their medical history. Those situations need to be discussed with your doctor. 

As for the rest? Every decision—medical and otherwise—involves imperfect knowledge and imperfect motives. We can do our best, and leave the judging to God. We will, of course, come up short. But we can rest, always, in God’s grace. Jesus’s sacrifice will cover everything we do. Our hope rests in Christ, who covers both our sins and our imperfect wisdom.

This post is for information only and is not intended to be viewed as medical advice. Please discuss all medical treatments with your physician.

This is part of an ongoing series on hormones. See my cornerstone post: Fearfully and Wonderfully Made: The Theology of Hormones.

1. Lessmeier TJ, Gamperling D, Johnson-Liddon V, et al. Unrecognized Paroxysmal Supraventricular Tachycardia: Potential for Misdiagnosis as Panic Disorder. Arch Intern Med. 1997;157(5):537–543. doi:10.1001/archinte.1997.00440260085013 ↩︎