Many women avoid hormone replacement therapy for fear that it will cause negative side effects like increased risk for breast cancer or blood clots. Of course no one wants to experience such scary and life threatening diseases. Many women have decided that the information is too confusing and because it is a natural part of aging they will just deal with the uncomfortable symptoms that come with the menopause transition. Symptoms of mood swings, fatigue, palpitations, hot flashes, night sweats, vaginal dryness, painful intercourse, memory issues and the list goes on. Not all women experience the change of life with the same symptoms or intensity of symptoms. Expect the unexpected should be the motto of menopause. Its like you were thrown into the Jumanji game against your will and now you are left to navigate your way through it with no clue as to how you got here or who you can trust to lead you out and back to your normal life. I am hoping to clear up for you briefly why the advice around menopause is contradictory and confusing and what the research actually says about taking hormones.
The Women’s Health Initiative or WHI was a study done 2002 and was supposed to be the definitive study on women’s health and the use of hormone replacement therapy or HRT. The study was meant to assess the effects of taking combined progesterone and estrogen in healthy post menopausal women and the rates of invasive breast cancer. The study was stopped prematurely when shocking headlines came out stating the study found clear and obvious increased risk of breast cancer, coronary heart disease, stroke and blood clots in the lung when taking HRT. That prescriptions for HRT fell dramatically that year as women and doctors began to advice against HRT. It would be hard to blame anyone who stopped taking HRT when such a large a prestigious study was halted as the reports rolled in that the thing being studied, HRT in post menopausal women was actually harming women. What exactly happened because there was mounds of research claiming its efficacy in years prior to the WHI study.
Its not fully clear why the study was halted and the shocking and scary headlines released. It turns out even some of the principal investigators and statisticians involved weren’t aware of what was happening until the results had already been printed. What is important to know is there were some major flaws in the study and even subsequent studies looking at the methodology and reporting of the WHI study that refute its initial claims. Those rebuttal studies did not make headlines and have gone somewhat unnoticed. What is listed below is some of the problems that should make us all question the results and advice of the WHI study:
1. The WHI reported statistics that were ALMOST statistically significant in regards to women’s risk of breast cancer. In any population we know there will be a number of people who get breast cancer. To say that an intervention, or in this case use of HRT increases the risk of breast cancer as the WHI study initially did, that number would have to surpass what the expected “normal” of a population. When they said almost statistically significant that means the number was not high enough to signify a relationship between those taking HRT and those who were not. To put it simply, statistically speaking that number of women would have breast cancer anyway. There are no grounds to point fingers and claim causation.
2. The WHI study claimed that the women enrolled in the study were healthy and a truly representative sample of post menopausal women. However, the average age of women in the study was 63, over 10 years past when the average age a women goes through menopause. Many were obese or overweight, being treated for high blood pressure and either current or past cigarette smokers. All of these factors alone puts a person at higher risk for health concerns like breast cancer, cardiovascular disease, strokes and blood clots.
3. I find this to be the most important issue. The WHI states they were testing estrogens and progesterones in their study. However, what they actually used was Premarin and Provera otherwise known as Prempro. Prempro is a chemically altered form of estrogen and progesterone, meaning not identical in structure and form to what is made in the body. Generally speaking the issues of increased cancer, heart disease, strokes and blood clots is due to this synthetically altered estrogens that are made partially from horse urine and synthetic progestins, much different from bio-identical estradiol and progesterone.
I could go on about the issues with this study and all the subsequent reviews that admit the WHI conclusions were wrong. It is important to know this, there is a lot of credible research that proves bio-identical hormones are safe and protective against health issues like cancer, heart disease osteoporosis and dementia. Bio-identical hormones look and are structured just like what is made in the body, they are safe to take and can make you not only feel better but also support a healthy body throughout your lifetime. There is no reason to just deal with the changes and discomforts that come with age. If you are ready to support your health now and in the future sign up for your initial consultation today!
