30 Sep Hormone Replacement Therapy for Menopausal Women: making informed choices based on facts
There are few topics in clinical medicine as divisive as hormone replacement therapy (HRT) for women suffering from menopausal symptoms. Recently, The Lancet published a study finding “definite” excess risks of breast cancer associated with the use of HRT (with the exception of vaginal estrogen), and included a supplementary editorial: “Menopausal hormones: definitive evidence for breast cancer.”
You may be interested in listening to this podcast by Dr. Peter Atia, who has a keen interest in exploring strategies and tactics to increase lifespan, healthspan, and well-being, and in optimizing cognitive, physical, and emotional health. It features Dr. Avrum Bluming, hematologist, medical oncologist, and emeritus clinical professor at USC, and Carol Tavris, Ph.D. and social psychologist, discussing their recent book, Estrogen Matters.
The co-authors shared with Dr. Atia, a summary of their particular objections to the study published in The Lancet, including:
- The investigators reported having analyzed the data records of 108,647 postmenopausal breast cancer patients collected from dozens of previously published reports and unpublished data sets, and compared each patient with up to four randomly selected matched controls without a breast cancer diagnosis. In the accompanying editorial, Joanne Katsopoulos of the Women’s College Research Institute in Toronto, writes: “The complexity of the study design makes it difficult to appraise the results and most of us will take the results on face value,” yet the title of the editorial remained “definitive evidence for breast cancer.”
- Even if their unclear assumptions are true and their difficult-to-understand calculations accurate, the Collaborative Group’s authors conclude that MHT administration would result in only one additional breast cancer for every 50 women who took it for 5 years, while taking estrogen alone would result in one additional breast cancer for every 200 women treated. We don’t intend to minimize the risks and fears associated with a diagnosis of breast cancer, but, as we show in Estrogen Matters, these absolute numbers indicate how non-frightening the results are, since these modest increases in absolute numbers are found in countless other medical studies of medications and treatments without generating panic about stopping them.
- The authors fail to say that even if their finding of a small increased risk is valid, breast cancer is currently curable in approximately 90% of newly diagnosed patients. Additionally, they fail to provide a balanced discussion of MHT’s (Menopausal Hormone Therapy) benefits, which include relief from incapacitating menopausal symptoms, and reductions in the risks of cardiovascular disease (responsible for killing seven times more women than breast cancer), osteoporotic hip fracture, and Alzheimer’s Disease.
Everywhere one turns, there is information and opinion about the role and safety of this form of therapy. Perhaps you have one too. If you’d like to learn more about Hormone Replacement Therapy, we encourage you to peruse the information and multiple links available here. Of course at DeerFields, we’re always happy to discuss Bioidentical Hormone Replacement Therapy for both women and men, with our clients — so if you’re a client with questions, we’re always happy to answer them.
If you’re new to DeerFields and are interested in becoming a client, why not begin with a Complimentary Consultation where you can meet our medical team, discuss your health and lifestyle goals, and learn more about what we have to offer.