Hormone Replacement Therapy
Hormone replacement therapy: what we know now 
by Dixie Mills, MD
For many years, millions of women entering menopause in America were prescribed Premarin or Prempro without much question. Premarin, a mixture of estrogens derived from the urine of a pregnant horse, and Prempro, a combination of horse estrogens and synthetic progesterone, served to replace the human sex hormones that naturally taper off in perimenopausal and menopausal women — primarily estrogen and progesterone.
The rationale for taking synthetic hormones was not only to quell women’s menopausal symptoms, but for their perceived ability to protect women against heart disease, build stronger bones, maintain youthful skin and support healthy brain function. But when the 2002 Women’s Health Initiative study results were first made public, both healthcare providers and their female patients were shocked to learn that hormone replacement therapy (HRT) was not as protective — or as safe — as they had once assumed.
The study results suggested that this type of HRT did not protect a woman from getting heart disease, and actually increased her risk of breast cancer, blood clotting and stroke. A reanalysis of this study completed in 2007 further suggested that actual heart disease risk depends on the age at which women begin HRT. But these results remain controversial, as yet another reanalysis this year (2008) concludes that hormone therapy is associated with an increased risk of stroke regardless of when a woman started the regime.
Sadly the media and many practitioners are painting all HRT with the same broad stroke. What I mean is that women are now being advised in medical alerts that these risks apply regardless of the type of hormones. The reality is that the reanalysis showed associated risks only for conjugated equine estrogens and synthetic progestins — not bioidentical hormones.
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Meanwhile, women continue to come to us every day, utterly confused and even scared about hormone replacement. All along, we’ve been devoted to clearing up the HRT story and setting the record straight for women. For many years we’ve been providing women with alternatives to conventional HRT, including bioidentical hormone replacement therapy (bHRT, or bio-HRT). We don’t know exactly what the risks are for every woman with natural hormones, either, as there haven’t been many large, definitive studies done on natural bioidentical hormone replacement therapy. But from the results of studies that have looked at bHRT thus far, and from what we’ve seen in our clinical practice in over 15 years of prescribing bio-HRT to our patients, bioHRT does not appear to have the same side effect profile as conventional HRT — particularly transdermal forms.
Bioidentical hormones share the exact same molecular structure with those in our bodies. Unlike conventional or synthetic forms of HRT, they are not patented and sold by pharmaceutical companies (unless they find a way to create a unique delivery system for them). But that’s the main reason why there have been very few large, well-designed studies to evaluate the risks and benefits of bio-HRT: it’s not as profitable as synthetic forms. As much as we rely on our clinical experience, we always, always want to see the science to back it up, and we recognize that clearly, more studies are needed.
Just speaking this truth has a way of stirring up controversy, and some serious efforts today are being made to shut down compounded bio-HRT as an option for women. We think that’s too bad. Because women deserve to know all of their options, to be fully informed of everything we’ve learned to date, and to have ready access to those options when they need them.
What you’ll find in the articles that follow is straightforward information on supporting your hormones and weaning yourself off of conventional hormone replacement therapy, if that’s what you decide is right for you. You’ll find answers to your questions about bHRT and how to decide if that could be a better choice for you, information on how to discuss bioidentical hormones with your practitioner, and our past press releases about hormone replacement therapy in the news. At Women to Women, we know that your body is sacred, and that educating yourself as much as possible will always lead you to better health. After years of experience, here is what we know about replacing hormones. We hope you’ll find the answers you’re looking for.
Our most popular resources on HRT and bioidentical hormones:
To access an article, just choose from the list of excerpts below. To find more articles, use the search function below. Don’t see a topic that’s important to you? Let us know.
Bioidentical hormones: are they right for you?
With Suzanne Somers’ decision to stay on bioidentical hormones for life, many women want to know if they should consider them as well. Here’s our perspective, after more than 15 years of using bioidentical hormones in practice.
Our perspective on the risks of HRT
When the Women’s Health Initiative results first came out, both women and their healthcare practitioners were fearful of the risks suddenly associated with hormone replacement therapy. But are these fears warranted? Here’s a balanced look at the risks of HRT.
What to expect when you’re stopping HRT
So many women try to get off hormone replacement therapy by going “cold turkey” and wind up suffering. Many give up and decide to go back on as a result of the rebound effect they experience. We’ve helped thousands of women wean themselves from HRT — safely and naturally. Learn what to expect, and allow yourself a smooth transition.- Hormone replacement therapy (HRT) — a history behind HRT and new alternatives, such as bioidentical hormones
Here’s a brief history behind the development of hormone replacement therapy by the pharmaceutical industry, and why so many women were abruptly taken off of it after the release of the 2002 Women’s Health Initiative study results. Learn more about how conventional forms of HRT compare to bioidentical hormone replacement therapy.
- Talking with your doctor about bioidentical hormones
Many doctors and healthcare practitioners don’t prescribe bioidentical hormones, primarily because they aren’t familiar with or don’t have time for the individualized approach they require. Here’s some practical advice on discussing bHRT with your doctor, so you can satisfy your needs without a struggle.
- FAQ’s on bioidentical hormones and other forms of HRT
There are so many questions out there about bioidentical hormones and hormone replacement therapy. Learn the distinctions between synthetic and bioidentical forms and how to decide what feels right for you from experienced women’s health practitioners.
- Press release on 2008 FDA news about bHRT
Bioidentical hormones are getting more press recently, after years of being on the sidelines. Unfortunately, the reporting only confuses matters more for women! Hear about the recent news concerning the FDA and bHRT, and why the implications matter more than ever now.
- Press release on the 2007 WHI reanalysis
The Women’s Health initiative study showed dangerous risks associated with conventional HRT and altered the way millions of women were being treated for their menopause symptoms. A reanalysis of the study doesn’t change much, despite the media’s claims about a reversal of findings.
- 2006 Press release on Suzanne Somers and bioidentical HRT
If you watched Suzanne Somers on the Larry King show, you may have been confused by the heated debate surrounding bioidentical hormones. Here’s a rational look at some of the elements and motivations behind the controversy.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
Original Publication Date: 9/02/2005
Last Modified: 05/29/2008
Principal Author: Dixie Mills, MD