Have you heard that hormone replacement therapy (HRT) causes breast cancer or heart attacks? Maybe your doctor has advised against it. But in reality, there’s no scientific justification for the apprehension surrounding HRT and estrogen therapy (ET).
There is a lot of misinformation and misunderstandings out there about HRT. This misinformation has become incredibly pervasive in the medical industry, leading to unnecessary suffering and even unnecessary death. In this blog, we’ll explain the different forms of HRT and where the misinformation comes from, how HRT can be beneficial for women, and why it’s important to seek treatment from a professional. Ultimately, we aim to help you understand what HRT is and if it might be beneficial for your health.
Types of Hormone Therapy
What is hormone replacement therapy? The Mayo Clinic defines HRT simply as medication that contains female hormones. It is used to replace the estrogen that is lost during menopause. HRT is most commonly prescribed to treat the symptoms of menopause, like hot flashes, fatigue, and insomnia.
There are two methods for prescribing HRT:
- Bioidentical hormones: this method is called Bioidentical Hormone Replacement Therapy (BHRT). BHRT utilizes bioidentical estrogen, meaning that the estrogen hormones are exactly the same as those produced by ovaries.
- Synthetic hormones: this form of HRT uses a man-made chemical that mimics progesterone, a human reproductive hormone. The synthetic chemical is called progestin.
Why BHRT Is Best
There is a molecular difference between bioidentical and synthetic hormones that plays a huge difference in patient outcomes. Research shows increased risk factors with non-biologically identical hormones, while bioidentical hormones are shown to be safe. It all boils down to the distinct differences in their molecular formulas and their significantly differing effects in the body.
BHRT is the clear winner for improving women’s health. Research shows some of the widely-felt benefits of BHRT (and ET in particular) to include:
- Up to 54% lower rates of heart attack and heart failure
- Up to 39% lower rate of stroke death
- Up to 50% lower rate of Alzheimer’s Disease
- Up to 28% lower rate of all-cause mortality
Studies also show a decrease in osteoporosis, breast cancer, and gallbladder disease (see sources here, here, and here).
Clearing up the Controversy
So where do the misunderstandings come from? It all started with a notorious study called the Women’s Health Initiative (WHI) trial, which studied HRT and its effects on 27,347 postmenopausal women aged 50–79 years. The results detailed a number of tremendously adverse health effects on the women who participated, such as breast cancer, heart disease, and Alzheimer’s. In the trial, women were given a pill that contained a synthetic progestin. The progestin in the pill was the main problem – it contributed to an increase in breast cancer and heart disease risks. Estrogen did not contribute to the negative outcomes.
Additionally, all of the women in the section of the WHI study that investigated Alzheimer’s were over 65 years old. Since older women starting hormones have a greater risk for blood clots and unstable plaque (especially with oral estrogen and synthetic progestins, which is what they were given), they were likely having mini-strokes. This is what caused the fairly sudden onset of dementia. Studies have shown that using transdermal estrogen (an application that poses less risk for blood clots) and starting estrogen at a younger age actually result in a significant reduction in dementia.
Further Science
There is no reason to suffer through menopause-induced hot flashes, vaginal dryness, fatigue, depressed mood, irritability, poor sleep, changes in your hair, your skin, your sex life, or even worse medical events due to common misconceptions about HRT.
Case in point: a groundbreaking Yale study looked at women aged 50-59 who had had a hysterectomy and were prescribed an ET treatment. ET was associated with a reduction in deaths from heart attacks and breast cancer in these women. Researchers estimated that 90,000 women have died because they did not continue on HRT after the conclusion of the study.
The key to a successful treatment path is getting treatment from a trusted professional who understands the best way to administer estrogen to you. There are a number of specific factors to consider:
When to Administer BHRT
In the WHI study, some women were given estrogen only. They were all given the same form of non-bioidentical estrogen and took it via an oral pill. But the ages at which these women started ET varied greatly, and that made a big difference in their outcomes.
Bottom line: starting estrogen within 10 years of menopause gives the best results. Starting when you are less than 60 years old can decrease the risk of heart attacks, strokes and death. The Endocrine Society found that heart attacks, heart failure, and all-cause mortality are reduced by 40% when HRT is initiated in women aged less than age 60 or within 10 years of menopause. They go on to note that women had decreased rates of breast cancer no matter how old they were when they started taking estrogen.
How to Administer BHRT
Oral estrogen increases the risk of blood clots, especially when it is not bioidentical (like the progestin in the WHI study). Using oral estrogen with a synthetic progestin increases the risk even further. Other factors that further increase the risk include being at an advanced age, obese, or a smoker.
Transdermal estrogen (treatment that is absorbed through the skin) does not increase the risk of blood clots. Taking this route and avoiding estrogen pills can reduce the risk of blood clots in many women.
BHRT at Moxie Medispa
As you can see, BHRT is a highly specialized form of care, and highly beneficial when administered effectively. Please reach out to us for an initial consultation with Moxie’s founder, Alex Foley, to see if BHRT is right for you and to determine your best therapy path.
Alex is a licensed medical professional who is passionate about advancing women’s health. She is fully up to date on the latest BHRT treatments and applications, and scours medical journals for the latest BHRT research – always looking for ways to improve her practice. Alex and the team of licensed professionals at Moxie Medispa are prepared to give you the personalized care you need to help you feel like your best self with BHRT.
