In 2002, the Women’s Health Initiative (WHI) released a study claiming that hormone replacement therapy increased the risk of breast cancer in women. Almost overnight, the use of HRT dropped significantly, leaving many women with few alternatives for managing their menopausal symptoms. In the twenty plus years since the release of this study, what have we learned? Is there new information? This is the topic I discuss with both patients and physicians the most!
WHI STUDY
Physicians and scientists look to the randomized control trial as the gold standard for medical information. But a study is only as good as it is designed, ie “Garbage in, garbage out.” The WHI study has so many well-known flaws that were apparent even when it was first publicized:
The sample of patients was unrepresentative of how hormones are used today
The findings were distorted
The findings were contradictory
The publication of results was rushed to press, without most of the investigators even being aware of this
By globally encouraging women to stop hormones, the WHI did real damage to womens’ quality of life and their long term health and mortality. Plus, when it was found that many of the conclusions were wrong, that information was never publicized as the initial study was. Sadly, this is a real disgrace to our scientific community.
WHAT HAPPENS IN MENOPAUSE
The definition of menopause is when the menstrual cycle ends. Symptoms such as hot flashes and night sweats can begin before your bleeding ends, and contine even after bleeding ends. The old teaching was that women experience menopause symptoms for 2 years then they go away; this is simply not true for all women. Plus there are a whole host of additional symptoms that can last 8 years or more after menopause and increasing with time, including:
Brain fog and memory issue
Fatigue
Weight gain, especially around the middle
Difficult sleeping
Bladder and pelvic floor dysfunction
Loss of sexual desire
Dry painful vagina
Headaches
Palpitations (many cardiologist aren’t even aware of this!)
WOMEN AND DISEASE
Women have an innate fear of breast cancer as we age. Currently, newly diagnosed breast cancer is CURED in over 90% of women! As those women now live longer, they are experienced more and more menopause symptoms due to their treatments. What good is it to cure a woman’s breast cancer, only to let her live for 20 more years feeling miserable!
In every decade of life, a woman’s risk of dying of heart disease is actually higher than dying from breast cancer, and that risk increases with each decade. But women have a misconception that young women die of breast cancer and old women die of heart disease; that’s simply not true.
Even as early as 1991, Dr Lee Goldman, head of cardiology at Harvard University, advocated the use of estrogen to prevent heart disease in women. Estrogen actually decreases a woman’s risk of heart disease by 50%. In men, statins are used to reduce the risk of heart attack, and they do work. However they do not have the same effect in women. Many physicians are not even aware of this, since most heart disease studies are done on white males, and results are extrapolated for women and other races.
If there is one thing women fear more than breast cancer, it may be Alzheimers disease. This fear is more founded; there is no cure for this type of dementia. Estrogen has been shown to decrease the cognitive decline associated with aging by 25-60%--that’s enormous! While it may not be a cure, we have no other options for this devastating disease.
HUMAN PSYCHOLOGY
So why do patiens and physicians alike have trouble changing their minds even when the evidence shows something different? It’s all about our brain psychology. Once we have a belief, we don’t want to be wrong. We tend to look for evidence that supports our belief, and minimize information that challenges it. This means we try to make the science match our preconceptions, rather than the other way around.
Physicians are not immune to this either. Doctors who have been practicing a long time strongly believe that they are doing the best for their patients. They I share that they are not doing the best, ie by denying their patient hormone replacement, or telling patients that hormones cause more harm than good. Those doctors at best may have trouble believing this evidence, or may even feel angry that I am challenging their belief. This is a natural response by our psychology.
LET’S TALK ABOUT NATURAL
Many men and women want a “natural” solution to their medical issues. I am a firm advocate of using healthy food and stress-reduction techniques as medicine. But just because something is natural, does not guarantee that it is safe. For example:
Arsenic is a completely natural compound; it of course is not at all safe
Labor and delivery is a completely natural function; before modern obstetric care, deliveries killed 1 in 20 mothers, so it is not always safe
What is NOT natural is women living for 20-30 years after menopause. Our ovaries were meant to make hormones so we could reproduce, then feed those babies breast milk. Our ovaries never expected to have to keep us healthy for any longer than that.
When any other endocrine organ in our body fails, like our thyroid or our adrenal gland, doctors have no reservations recommending replacement. The ovaries should be no different. When our ovaries start to fail, replacement of all the hormones they provide is the only natural solution for women. We are your hormone replacement experts, providing safe and effective treatment for men and women for over 20 years!
SCHEDULE YOUR HORMONE CONSULTATION AT FOUNDATIONS AT MAITLAND
At Foundations at Maitland, in Maitland FL, we offer a full range of non-surgical treatments to help you reach your aesthetic, wellness, and sexual goals. Our providers are highly trained and experienced. We are led by our double-board certified surgeon, Dr Kristin Jackson, who has personally developed all treatment protocols and is closely involved in the day-to-day operations of our medical spa. With her extensive training in all non-surgical cosmetic treatments as well as over 20 years of surgical experience, Dr Jackson is uniquely qualified to ensure our medical spa provides you with the highest standards of quality care and safety.
If you are looking for hormone replacement doctors or anti-aging doctors near you, we can help! Contact us today for your complimentary consultation!