Where’s the Good News About Hormone Therapy?

Menopausal hormone therapy misunderstood by many

pensive woman in 50s

Good news should be newsworthy. However, there has been a constant stream of negative news about menopausal hormone therapy (MHT) in the last 10-plus years since the Women’s Health Initiative (WHI), a 15-year research program to address health issues in postmenopausal women.

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Apparently, bad news sells. However, misinformation kills.

The good news about menopausal hormone therapy

Several years ago, research was released from the estrogen-only arm of the WHI in women with hysterectomy.

It showed that the women had no increase in breast cancer and a reduced risk of breast cancer when they took the estrogen tablet daily compared to those who took a placebo.

That is good news and big news.

Also, although the WHI overall showed no change in mortality (death rates) compared to placebo, further analysis of women closer in age to menopause taking MHT showed they had a reduced risk for death and lower incidence of cardiovascular disease. Cholesterol-lowering medicine in women when used for primary prevention did not show this benefit.

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More studies support MHT

Further studies, including the KEEPS trial and DOPS (previously reviewed in my Speaking of Women’s Health blog post, “The Anti-Hormone Party is Over” ) continued with very positive news for postmenopausal women who need hormone therapy and for those women who may be hormonally deficient and needing replacement therapy for preventive effects as well as treatment effects.

Nearly, every day in my practice, I see a woman who needs MHT but is petrified to take prescribed therapy because of the very imbalanced and biased information that has been promulgated, not only by the media but by medical organizations that have been unduly influenced by the WHI and the WHI investigators.

Exaggerating the risks of MHT

Recently a mathematical study was published making the very point that up to 90,000 American women with hysterectomies may have died prematurely because of avoiding estrogen therapy! That’s a big number.

So yes, misinformation, fear mongering, exaggerating the risks of MHT and downplaying the benefits has led to a reduced quality of life for many symptomatic menopausal women who have foregone or forsaken therapy — or not even been offered therapy by their equally misinformed healthcare providers.

It has also potentially cost women their lives in terms of translating to more fractures, higher death rates and consequently a shorter lifespan. Untold misery for symptomatic women and their families has needlessly occurred. That fact, I am absolutely certain of.

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Who will benefit from MHT?

Now in case someone (e.g., WHI investigator devotee) accuses me of being an “estrogen evangelist,” let me state that not all menopausal and postmenopausal women are hormonally deficient. Menopause is a natural life event. So is death. Good health and longevity for women in the post-reproductive years of life is actually bonus years.

The following all play a role in determining who best benefits from MHT:

  • Quality and quantity of life
  • Symptoms
  • Personal preferences
  • Values
  • Lifestyle
  • Concomitant medical conditions

Fortunately, there are also non-hormonal options available for women who cannot or will not use MHT.

Speaking of Women’s Health

Holly L. Thacker, MD

Holly L. Thacker, MD

Holly L. Thacker, MD, Director of the Center for Specialized Women's Health and Executive Director of Speaking of Women’s Health, is nationally known for her leadership in women's health.
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