Hormone Replacement Therapy (HRT) is like a vampire. No scientific wounds ever kill it, because the financial motivation to keep pushing it is simply too great for doctors to resist.
According to HRT doctors, menopause is a disease caused by declining hormone levels, not a natural process. Natural hormones, such as phytoestrogens are not a desirable solution (because they are not patentable), so artificial estrogens and progesterone must be used.
The precursor to HRT was estrogen replacement therapy (ERT), touted in the mid-1960’s as a way for women to stop the aging process and to eliminate the unpleasant symptoms of menopause – hot flashes, vaginal dryness, migraines and more.
The first blow came in 1975 with a study showing the risk of endometrial cancer was 4.5 times greater in women taking estrogen (14 times greater if taken for more than 7 years)[1]. There was some evidence that including progesterone would reduce this risk, thus HRT was born (using artificial progestin).
The risk of cancer still exists with HRT. A 1995 study estimated the risk of fatal ovarian cancer as 15-71% higher, depending on the duration of HRT [2]. A 2002 study showed a 60-85% increased risk of breast cancer [3]. Risk of stroke has been shown to be about 50% higher [4].
In other cases, the touted benefits have failed to be proven. Recent studies have showed that HRT does not slow down the onset of Alzheimer’s [5] does not measurably improve quality of life [6] nor lower rates of coronary heart disease [7].
Hormones are big business for many doctors and drug companies. Pharmaceutical industry-sponsored websites, and even government health information sites, still promote ERT and HRT – and downplay the risks.
Women approaching menopause should consider the risks of the ‘quick fix’ approach embodied in HRT, and understand that doctor’s enthusiasm may arise from drug company pharmaceutical marketing efforts. Alternative approaches based on diet, exercise and possibly natural estrogens may be more successful and certainly carry less risk.
[1] Smith DC et al. Association of exogenous estrogen and endometrial carcinoma. NEJM. 1975 Dec 4; 293(23): 1164-7.
[2] Rodriguez C et al. Estrogen replacement therapy and fatal ovarian cancer. Am J Epidemiol. 1995 May 1; 141(9): 828-35.
[3] Chen C-L et al. Hormone Replacement Therapy in Relation to Breast Cancer . JAMA. 2002 Feb 13; 287(6).
[4] Grodstein F et al. Postmenopausal hormone therapy and cognitive function in healthy older women. Ann Intern Med. 2000 Dec 19; 133(12):933-41.
[5] Chen GF et al. Postmenopausal hormone therapy and cognitive function in healthy older women. J Am Geriatr Soc. 2000 Jul; 48(7): 746-52.
[6] Hlatky MA et al. Quality-of-Life and depressive symptoms in postmenopausal women after receiving hormone therapy. JAMA. 2002 Feb 6; 287(5): 591-7.
[7] Hulley S et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998 Aug 19; 280(7): 605-13.
Copyright © David Crowe,