Hormone Replacement STILL Controversial

Hormone replacement is still controversial. In the 1960's women were ecstatic to finally have a remedy to the hot flashes, night sweats, insomnia, mood swings, low libido issues and doctors were more than willing and able to write the prescription to alleviate their symptoms. However, after the publications of the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) studies, doubts were raised about the increased risk of hormone therapy. Physicians became reluctant to prescribe hormone replacement because of the widely publicized reports that estrogens cause endometrial cancer, that combination therapy (via Prempro) increased breast cancer and stroke risks. Even so, estrogen therapy continues to be popular among many patients.

First, we now know that oral metabolism of estradiol is DIFFERENT from transdermal estradiol. We also now know that there IS a difference between PROGESTINS and NATURAL PROGESTERONE.

Second, we also know that long term estrogen deficiency can and often does lead to osteoporosis and related fracture complications, atherosclerotic heart disease, psychogenic manifestations (depression, anxiety, insomnia, irritability), alzheimer's disease, increase risk for colon cancer and who knows we may discover even more disease and health related disorders associated with hormone deficiency over the next 100 years.

Third, we now know that the belief that estrogen treatment causes endometrial cancer is no longer valid and that the incidence of cancer (of the endometrium, or of the breast) need not increase as a result of long term estrogen therapy if cyclic progesterone in adequate dosages are added to the estrogen replacement therapy.