Hormone Therapy History, Myths, Facts, and Benefits

Why is hormone replacement therapy (HRT) still a topic of heated debate, decades after its initial controversy? And, more importantly, is it safe today? This article seeks to clear the fog around HRT by addressing these pressing questions, providing you with the most up-to-date science on bioidentical hormones. Learn why millions of women are rediscovering the life-enhancing benefits of HRT without the old fears attached.

We are finally starting to see new research supporting the safety of the use of menopausal hormone therapy and showing the numerous benefits. More practitioners and patients are starting to experience the numerous benefits.

But it wasn’t always like this.

Hormone History Rollercoaster

For the past two decades, hormone therapy for women has been a controversial rollercoaster.

How did hormone therapy for women get a bad rep?

And why are some mainstream practitioners still behind the times, still spreading fear about this powerful therapy for women?

There was a time when women were treated based on the concept of “feminine forever.” The medical establishment promoted the idea that menopause was a disease that could be cured with estrogen.

Starting in the 1940’s, Premarin was introduced as a menopausal hormone therapy. This is a pharmaceutical product made from pregnant horses’ (mares’) urine —pregnant/mare/urine = Premarin. Really. If it sounds off-putting, the reported health results were, eventually, even worse.

At the broadest pharmacological level, Premarin fell under the category of “estrogens or estrogen derivatives”. Like all medications in this class, it acts by mimicking the behavior of naturally occurring estrogen hormones in the body to develop and maintain the female reproductive system as “feminine forever.”

Hormone Therapy Misuse, Corrected

Premarin was widely prescribed on its own until the 1970’s when researchers discovered a massive surge in endometrial (uterine) cancer among women taking Premarin. Naturally, this undermined the public’s confidence in hormone therapy in general.

Then, in the 1980’s, a solution was found, which was adding a synthetic progesterone type of medication to the estrogen regimen. It is called Provera, the brand name for medroxyprogesterone acetate. This balanced out estrogen’s effect on the lining of the uterus and eliminated the increased risk for uterine cancer.

This caused a resurgence in the Premarin market for the next 25 years. Although it was still not free from controversy, as many doctors and patients turned away from the therapy because of concerns about animal welfare and the methods of harvesting it from pregnant horses.

Overreaction Ignites Fear of Hormone Therapy

Despite the controversy, the use of this synthetic hormone therapy was widespread until a new bombshell in 2002. Wyeth, the company that made Premarin, released results of a study called the Women’s Health Initiative. They had expected to show that using a combination of Premarin and a progestin in a product called Prempro was a great boon to women. However, the study was shut down when preliminary data suggested that the treatment slightly increased the risks of breast cancer, strokes, heart attacks, and blood clots.

In what was surely a dramatic overreaction to this ‘slight’ possibility found in an unfinished study, almost all hormone therapy in the United States and in Europe came to a screeching halt. It was not the first scare related to hormone therapy, and so it is, perhaps, understandable that it caused a bit of a panic.

As a result, the FDA stepped in by January 2003 and mandated its most severe warning—a “black box” warning—on Premarin and all other menopausal hormone therapies, including non-synthetic, bio-identical hormone therapy.

Sadly, it is estimated that tens of thousands of women died–not due to the side effects that may have been associated with a single, incomplete study of a single drug, but due to missing out on all hormone treatment altogether for decades. It has taken more than 20 years for the medical establishment to sort out the information and realize the mistake.

Is Menopausal Hormone Therapy Safe?

The reality is that the problem with the Women’s Health Initiative’s outcome was that bioidentical hormones were not used. As it turns out, the synthetic form of progesterone, called Provera, was a stimulant that caused breast cancer. Believe it or not, this product is still on the market. The natural form of progesterone does not cause any increased risk of breast cancer.

What we know now is that the proper use of estrogen and progesterone

• helps women with the many physical and psychological changes of the menopause transition.
• have long-term health benefits, such as improving sleep, maintaining bone density, and maintaining muscle mass.
• when combined with exercise, it can help prevent the loss of muscle mass, strength, and performance.
• are also associated with improved brain function and lower mortality.
• reduce the risk of neurodegenerative diseases, such as Alzheimer’s.
• reduce the risk of cardiovascular disease in women who start hormone therapy at age 60 or earlier.
• reduce all-cause mortality in women who start hormone therapy prior to age 60 by 40%.
• can help a lot with chronic pain conditions like Burning Mouth Syndrome.

Sadly, it has taken 24 years for the medical establishment to start changing its understanding and stop being so resistant to prescribing hormone therapy to women. Of course, the anti-aging, longevity, and functional medicine practitioners have been on board the entire time, but overall, our numbers are small, and we have not had enough influence to change the viewpoint of the larger medical establishment.

Fortunately, patients have been proactive in doing research to find out what they need and where to get it. It turns out that the type of formulation and the route of administration are important factors in whether hormones are beneficial or harmful. The timing of initiation of hormone use is also very important, with most benefits being shown by starting hormones within 10 years of the menopause transition.

Lingering Myths and Fears About Hormone Therapy

 

Myth #1: The term bioidentical is a marketing term and has no true meaning

Truth:
Bioidentical hormones are safer and cause fewer side effects than synthetic hormones like Provera or the animal-derived, oral hormones like Premarin.

Myth #2: Hormones cause cancer

Truth:
The reality is that the problem with the Women’s Health Initiative’s outcome was that bioidentical hormones were not used. As it turns out, the synthetic form of progesterone, called Provera, was a stimulant that caused breast cancer. Believe it or not, this product is still on the market. The natural form of progesterone does not cause any increased risk of breast cancer.

Myth #3: Hormones cause heart disease and strokes

Truth:
The form of estrogen that was used in the Women’s Health Initiative, Premarin, was an oral formulation that caused increased blood clotting and, therefore, increased risk of stroke and heart attacks. In addition, the women in the study had an average age of 63. They most likely had already developed some cardiovascular disease and plaque before they started on hormones. This, of course, was a problem combined with increased clotting, which then leads to strokes and heart attacks. Currently, most estrogen formulations are the bioidentical form of the estrogens that our own bodies make. They are usually given as a skin patch, cream, or gel. This formulation is safer than a pill because it does not increase the risk of blood clotting.

Myth #4: Hormones cause Alzheimer’s disease

Truth:
Premarin plus Provera increases dementia due to mini strokes, not Alzheimer’s. This was shown in the Women’s Health Initiative. Unfortunately, this has been interpreted by the medical establishment as an increased risk of Alzheimer’s disease. In reality, bioidentical hormones decrease the risk of Alzheimer’s disease by 80%.

Hormone Therapy for Burning Mouth Syndrome

Aside from the many benefits of hormone replacement therapy mentioned above, there is evidence that hormone therapy is helpful for chronic pain conditions. Burning mouth syndrome is a chronic neuropathic pain condition that mainly affects perimenopausal and menopausal women. In our experience, the use of a balanced hormone program has resulted in relief for the majority of those suffering from this pain condition.

There is still much work to be done to get the conventional medical establishment on board with the benefits of hormone replacement therapy. However, with positive publicity starting to get out in the press and pressure from the public, this will eventually turn around to benefit women.