Hormone Replacement Therapy, Menopause care
Much has been learned about hormone replacement over the last 30 years, and some of it is quite confusing. Since the Women’s Health Initiative study, other robust studies have shown more favorable findings, many originating out of Europe. In Finland, a study of over 400,000 women showed a decrease in cardiovascular risk and lower mortality overall in women taking estrogen and norethindrone. In a French study following almost 100,000 women, those taking estrogen and progesterone in formulations more exact to what the body makes had the above benefits and no increased risk of breast cancer. Further studies showed transdermal estrogen has less of a risk of clotting problems. This is not to say that hormones are for every woman, but taking hormones identical to the estrogen and progesterone made by the body can afford many benefits.
Why you might want to consider taking hormone replacement
Here’s why you might want to consider taking hormone replacement. Menopausal hormone therapy decreases colon cancer, osteoporosis, hip fractures, tooth loss, depression, vaginal irritation and infections, weight gain, and hot flashes. Hormone replacement improves continence and sleep. And per a recent scientific statement from the American Heart Association,
In the most recent Cochrane systematic review evaluating RCTs [randomized clinical trials] of MHT [menopausal hormone therapy] for preventing CHD [cardiovascular heart disease] in postmenopausal women “women initiating MHT at <60 years of age or <10 years since menopause, CHD risk was reduced by roughly half (RR, 0.52 [95% CI, 0.29–0.96]) and all-cause mortality by 30% (RR, 0.70 [95% CI, 0.52–0.95]). Venous thromboembolism was increased (RR, 1.74 [95% CI, 1.11–2.73]), but there was no evidence of an excess risk of stroke with MHT.”
If started before 60 years of age…
Let me reiterate this statement, hormone replacement therapy, if started before 60 years of age, cuts heart attacks in half and lowers death by 30%. What if you’re over 60 years of age? If you are healthy and do not smoke, there’s evidence through the Finnish study above that you will probably also benefit from hormone therapy.
Sorry if this is a bit sciency, but a lot of information about hormones can be misleading. At Hormonal Well-Being, we will evaluate your potential risks and benefits and tailor hormone recommendations to you.
Chester RC, Kling JM, Manson JE. What the Women’s Health Initiative has taught us about menopausal hormone therapy. Clin Cardiol. 2018 Feb;41(2):247-252. doi: 10.1002/clc.22891. Epub 2018 Mar 1. PMID: 29493798; PMCID: PMC6490107.
Clavel-Chapelon F, van Liere MJ, Giubout C, Niravong MY, Goulard H, Le Corre C, Hoang LA, Amoyel J, Auquier A, Duquesnel E. E3N, a French cohort study on cancer risk factors. E3N Group. Etude Epidémiologique auprès de femmes de l’Education Nationale. Eur J Cancer Prev. 1997 Oct;6(5):473-8. doi: 10.1097/00008469-199710000-00007. PMID: 9466118.
El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick ML, Allison MA; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 22;142(25):e506-e532. doi: 10.1161/CIR.0000000000000912. Epub 2020 Nov 30. PMID: 33251828.
Mikkola, T., Tuomikoski, P., Lyytinen, H., Korhonen, P., Hoti, F., Vattulainen, P., Gissler, M., Ylikorkala, O., (2015) Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality. Menopause: The Journal of The North American Menopause Society, Vol. 22 No. 9 pp.976-983