The thinking continues to get more positive about menopausal hormones. The hysteria about hormones started when data from the Womenâ€™s Health Initiative Study was misinterpreted and misquoted in the media.Â For the most part, the women in the study were too old to start taking hormones and had no menopausal symptoms.Â Specialized physicians like Harvardâ€™s Dr. Alan Altman M.D. were mystified by the reporting, since they could clearly see the limitations of the study and had seen women starting hormones in their 50â€™s thrive on brand name, FDA-approved bioidentical patches and gels. So, here are the facts (in his own words) on the WHI from an expert and author who understood from the beginning what the study showed and did not show.Â
â€œThe WHI did not study all â€œhormones.”Â In fact, the ONLY hormones studied were PremproÂ© and PremarinÂ© (non-human identical hormones and only pill form) - The WHI Study was not really about â€œall womenâ€â€¦average age of the women studied were 12 years after menopauseâ€¦averaged 64 years old at outset of study – What WHI actually did show was that a 72-year old woman should not be started on oral PremproÂ© to protect her heart.
- Any small increase in dementia was seen only in women ages 75 to 80! (Numerous studies of women starting HT at the appropriate age close to their final menstrual period have demonstrated a 50% to 65% decrease in the risk of Alzheimerâ€™s disease.) Oral estrogens increase the risk of blood clots and of strokes related to blood clots. (Weâ€™ve known this for 30+ years, however we see no increase in clots or strokes on non-oral estrogen.)Â Non-oral estrogen (specifically estradiol via transdermal patch, gel or transvaginal ring) AND natural micronized progesterone taken orally is presently safer, healthier and more â€œnaturalâ€ for use in hormone therapy.
- Women saw no quality of life benefits from taking these hormones because 88% of the women in the study had no menopausal symptoms to begin with.Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â
- There was a slight increase in breast cancer risk when on PremproÂ© (estrogen and progestin) and slight decrease on PremarinÂ© (estrogen therapy). There is a serious lack of consensus in the data looking at estrogen use and breast cancer risk.Â There appears to be a risk of breast cancer concerned with use of the potent synthetic progestin (or Medroxyprogesterone Acetate – MPA) that was used in the WHI.”Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â
* Alan Altman, MD is Assistant Clinical Professor of OB/GYN and Reproductive Biology at Harvard Medical School.Â He is a practicing gynecologist, specializing in peri and post-menopausal health, hormone replacement therapy and female sexuality.Â