NAPLES PHYSICIAN HIGHLIGHTS TOP FIVE HORMONE REPLACEMENT THERAPY MYTHS

While hormone replacement therapy (HRT) is proven effective at treating menopause symptoms, many women remain hesitant about undergoing the treatment. This hesitancy is primarily due to 2002 findings that emerged from an ongoing National Institute of Health study called the Women’s Health Initiative (WHI). Those findings acknowledged HRT benefits but determined that the therapy significantly increased the risk of breast cancer, blood clots, stroke, and other health issues. HRT’s alleged breast cancer risk made the headlines, and the number of U.S. women undergoing the therapy plummeted by more than 80%.

Follow-up studies identified significant flaws in the WHI’s research methodologies, and other research has clearly determined that HRT benefits outweigh potential health risks. In fact, a statistical study of 30 clinical trials determined that women who underwent HRT before age 60 had an almost 40% lower risk of death than women who didn’t.

Once a woman becomes estrogen deficient during menopause, studies show there is a significant increased risk of death from heart disease after 12 months. After at least 40 million women went off HRT due to the flawed WHI study, heart disease became the number one killer of menopausal women. Plus, not to mention, testosterone has proven to decrease the risk of a woman developing breast cancer by 38%.

The negative impact of the flawed 2002 WHI data remains deeply ingrained two decades later, causing many women and healthcare providers to significantly overestimate the risk of HRT. As a long-term provider of HRT, internal medicine specialist Dr. Diane Brzezinski, D.O., frequently encounters this first-hand from her Southwest Florida-area patients. Many of her menopausal patients still express significant concerns about the risk of breast cancer and other health issues when she recommends hormone replacement therapy in her Naples clinic.

With this in mind, let’s look at the top five myths surrounding the use of HRT to treat menopause symptoms.

1. HRT INCREASES RISK OF BREAST CANCER AND HEART DISEASE

A primary shortcoming of the 2002 WHI data was that 70% of the study participants were over age 60, which significantly skewed the overall incidence of reported adverse health risks. Subsequent research has determined that HRT may increase cancer and heart disease risk in patients over 60 but that some hormone balances used in the therapy can decrease the risk for those under 60.

2. HRT SHOULD NOT BE USED TO TREAT PREMATURE MENOPAUSE

This myth may have emerged due to a faulty association between the prevalence of breast cancer in younger women and the 2002 WHI data’s focus on breast cancer risks. Whatever the case, women who experience premature menopause face an increased risk of overall mortality and numerous other diseases and adverse health impacts. These risks are so significant that the medical field recognizes hormone therapy as a first-line treatment to reduce the health risks and alleviate early menopause symptoms.

For the record, Dr. B successfully treated her premature menopause with HRT.

3. BIOIDENTICAL HORMONES ARE NOT AS SAFE AS NATURAL ONES

Women are often confused about the differences between “natural” and “bioidentical” hormones. There’s plenty of information (and misinformation) about the two, with claims often supporting the health benefits and risks of one over the other. The FDA has essentially determined that bioidentical hormones have the same risk/benefit profile as natural ones. Derived from plant sources, bioidentical hormones have the same chemical and molecular structure as the ones we produce naturally. To further confuse the issue, most “natural” hormones—often referred to as “traditional”—used for HRT are actually synthetic compounds. We’ve reviewed the differences between these hormone types in a previous blog post.

4. HRT SHOULD NOT BE USED AS A LONG-TERM MENOPAUSAL TREATMENT

Women can generally undergo HRT for as long as they experience menopause symptoms. The therapy’s duration depends primarily on the age when she started it, the progression of menopause, and its effectiveness at treating symptoms. Health risks associated with long-term hormone use are most pronounced in those with underlying conditions, over age 60, and those undergoing HRT for more than 10 years.

5. ORAL HRT IS MORE EFFECTIVE AT TREATING MENOPAUSE

There is no evidence that oral forms of HRT are more effective at treating menopause symptoms than other delivery methods like transdermal patches, gels, and pellets inserted under the skin. In fact, many researchers believe pellets have the edge over oral delivery because they offer consistent hormone absorption and utilization rates. Oral forms and gels provide inconsistent hormone levels throughout the day, limiting their effectiveness and making them more prone to causing side effects.

LEARN MORE ABOUT HRT FOR MENOPAUSE AT DR. B’S NAPLES CLINIC

To learn more about how hormone replacement therapy can safely help relieve your menopause symptoms, consult with Dr. B. You can schedule your HRT appointment at Dr. B’s Naples, Florida, internal medicine practice by calling (239) 261-9990.