How Hormone Therapy Got a Bad Name (And Why It Never Should Have)
You may be wondering why so many people (including many doctors) are so confused about hormone replacement therapy for women. The answer lies predominantly with a study conducted in the 1990’s called The Women’s Health Initiative (WHI) study. From its inception, this study was not well designed; and the conclusions that were drawn from it were fundamentally flawed. Unfortunately, its negative impact has been far-reaching and long lasting with regard to hormone replacement for women.
Why Were Women Told to Stop Taking Hormones?
The WHI study started enrolling women (all 161,800 of them) between 1993 and 1998. This study was paid for and sponsored by the pharmaceutical company that makes PremPro (a combination of synthetic estrogen derived from the urine of pregnant horses, and synthetic progesterone, also known as progestin). The study was stopped in 2002 when it became evident that there was an unmistakable increase in heart disease, breast cancer, stroke and blood clots in women taking this medication.
The erroneous conclusion was drawn that all hormone replacement therapy for women is bad, and that it should be stopped. Just like that, the baby was thrown out with the bathwater, and women stopped taking hormones.
The Truth About the WHI Study
On closer examination it was discovered that:
- Only the women on estrogen and synthetic progesterone (also known as progestin) suffered adverse results to their health. Those on estrogen only did not suffer adverse effects.
- The majority of women in this study were more than 10 years past the onset of menopause. Those in the study who started hormone treatment at younger ages experienced positive results, including a decrease in breast cancer.
- A majority of the women in the study were overweight (which in and of itself significantly increases the risk for developing breast cancer).
- The results were skewed by the high percentage of women who dropped out of the study (42%).
- The women in the study took the medication orally, which researchers later found was in part responsible for adverse results.
- And the list goes on.
The Really Good News About Hormone Therapy for Women
Numerous studies have emerged since the WHI study that attest to the safety and health benefits of hormone replacement:
- WHI follow-up study on 8,000 women taking estrogen only (without synthetic progestin) for 7.1 years. They were 18% to 31% less likely to develop breast cancer (depending upon the type of breast cancer being looked at) than those on placebo.
- Puget Sound, 25-year study–those on estrogen had no increased risk of breast cancer. Those on estrogen and synthetic progestin experienced an increased risk.
- Scandinavian study–30,000 women over 11 years–results were the same as the Puget Sound study.
- Department of Oncology, University Sweden–30,000 women over 10 years–results were the same as above.
- French study–7,000 women over 8.3 years–no increase in incidents of breast cancer.
- Dr. Alvin Bloom–254 breast cancer survivors over 7 years and counting–no increase in incidence of breast cancer.
- University of Toronto–472 women who tested positive for BRCA1 (a genetic marker that indicates a high risk for developing breast cancer)–42% fewer incidents of breast cancer than those testing positive for BRCA1 not on HRT.
- Finnish study–110,000 women over 10 years–no increase in breast cancer.
- And the list goes on…
What We’ve Learned About Hormone Therapy Since the WHI Study
Some conclusions that can be drawn from these and other studies:
- The dangers of hormone replacement have been oversimplified, generalized, and misunderstood.
- It’s best to start bioidentical hormone replacement therapy (BHRT) early in menopause.
- BHRT needs to be a balanced program including several hormones—it should not include estrogen only.
- When replacing hormones, it’s important to stay as close to natural or bioidentical as possible—not synthetic. Natural or bioidentical is defined as hormones originating from plant sources, that when placed under a comparison microscope, are identical to those produced by a woman’s body.
- Estrogen should not be taken orally and is at its safest and most effective when applied topically.
- Estrogen replacement is safest when two forms of bioidentical estrogen are mixed together in a formulation called Biest. The two estrogens used in Biest are estradiol and estriol. Estriol is the milder of the two and is actually breast protective.
- Estrogen should be balanced with natural or bioidentical progesterone. Synthetic progesterone (also known as progestin) is dangerous. We can’t overstate this enough.
- A one-size-fits-all approach should not be taken. Dosing must be individualized depending upon each woman’s unique physiological needs.
Contact us directly to learn more about the benefits of bioidential hormone replacement therapy. You can reach us at (800) 859-7511, or request a consultation through our contact form.