Why Are Hormones "Ok" Now?
This was a very honest and straightforward question I was asked a couple of weeks ago. The simple answer is that menopausal hormone therapy was never unsafe. The preponderance of data reveals that menopausal hormone therapy (MHT) has the following benefits when taken within 10 years of menopause:
- MHT reduces the risk of heart disease,
- MHT preserves bone density
- MHT preserves skin elasticity and moisture
- MHT preserves sexual function
- MHT preserves bladder function
- MHT increases a woman’s longevity
- MHT improves brain function
- MHT decreases the risk of heart disease
- MHT decreases the risk of colon cancer
A more complicated answer to the question of “why are hormones ok now?” involves a detailed explanation of what scientific studies showed prior to and since the Women’s Health Initiative (the WHI) of 2002, how the WHI was flawed in its design and interpretation and what we learned from the WHI. We have a more detailed post on this in the works, but for now, here's what you need to know.
The WHI was a groundbreaking study in that it was a study funded by the NIH (National Institute of Health) looking only at an issue that affects women - menopause. For that, I am grateful. However, the study was extremely flawed and ended up creating anxiety and uncertainty in the world of women's health. Some of the many flaws in the WHI study were (1) the choice of progestin, (2) the early halting of the study for a non-significant reason, (3) the authors’ misinterpretation of the data, and (4) the authors’ delayed apology for their misinterpretation. Despite initial sensationalized reports to the contrary, the WHI study showed NO increased risk of breast cancer with estrogen; in fact, the WHI showed that women on estrogen alone were less likely to die of breast cancer and less likely to die from all causes.
In their book, Estrogen Matters, Dr. Avrum Bluming and Dr. Carol Tavris have taken great pains to lay out the support for the benefits of menopausal hormone therapy, the lack of evidence of harm, and the reason the medical community and patients were so misled for so long. I encourage every woman to read this book. Over the past 2 years, I’ve done my own research on hormone therapy for menopause and reviewed the available clinical trials, and I agree wholeheartedly with Drs. Bluming and Tavris that when prescribed responsibly, MHT is more than "OK", it is in fact beneficial to midlife women's health.
As an internist and proponent of women's health, I was overjoyed when I read Estrogen Matters and realized how well Drs. Bluming and Tavris were able to tell the story of hormone therapy's ups and downs, how confused the medical community became when the Women's Health Initiative study was released, and how we can all re-examine the data and make sense of it. The messages in this book are clear, evidence-based and balanced. I hope this will help all medical professionals and patients realize the benefits of hormone replacement therapy for the vast majority of women.
Dr. Leslie Meserve
Co-Founder and Chief Medical Officer, CurieMD
1. Estrogen Matters by Dr. Avrum Bluming and Dr. Carol Tavris