By Avrum Bluming and Carol Tavris
Jan 31, 2019
Over its long history, hormone replacement therapy for women in menopause has been the Jekyll and Hyde of medications. It has careened from savior to villain, from cure-all for every female complaint to poison. And when in 2002, the National Institutes of Health-funded, $1-billion Women’s Health Initiative loudly announced that women taking HRT had an increased risk of breast cancer, its role as “savior” all but disappeared. Other dire alleged consequences included heart disease, stroke, dementia and even “all-cause mortality.”
Understandably, millions of women panicked, along with much of the medical establishment, and dropped the option of hormone therapy altogether. (Estrogen is given by itself to women who have had hysterectomies and, as HRT, in combination with progesterone to those who still have a uterus.)
The good news about estrogen has been lost: namely that more than 70 years of findings from animal studies, human studies, observational studies and randomized controlled studies demonstrate the benefits of estrogen. Most remarkably, the research shows the failure of the accepted hypothesis that estrogen causes breast cancer. In fact, estrogen has been successfully used as a treatment for women with the disease, and, remarkably, it can often be safely administered to most women who have had breast cancer.
Women on hormone replacement therapy live, on average, several years longer than those not taking it.
Heart disease, not cancer, is the leading cause of death for women in every decade of their lives (it is even the leading cause of death for breast cancer survivors). Hormone replacement therapy can decrease that risk by 30% to 50%. It can also cut in half the risk of osteoporotic hip fracture — a crucial benefit because as many older women die annually after breaking a hip as die of breast cancer. And numerous animal and human studies indicate that estrogen is the only intervention that prevents or reduces the risk of Alzheimer’s disease and other forms of dementia in women.
HRT is the most effective treatment for familiar menopausal symptoms, including hot flashes, night sweats, insomnia, vaginal dryness and loss of sexual desire, and for the less familiar symptoms: heart palpitations, joint and muscle aches, headaches, bladder problems and depression. Forget the black cohosh and chaste tree; they are no better than placebos.
Finally, because of estrogen’s benefits for heart, brain and bones, women on hormone replacement therapy live, on average, several years longer than those not taking it. This is one reason that the North American Menopause Society and 30 other international groups concluded that “there are no data to support routine discontinuation [of HRT] in women age 65 years.”