Please Explain: Hormone Replacement Therapy

Friday, April 15, 2011

The hormones estrogen and progestin have been prescribed to women to relieve symptoms of menopause. Studies have shown that hormone replacement therapy can increase the risk of cancer, but earlier this month, a new study showed that among some women, it can reduce the risk of breast cancer and heart attack. The conflicting information has left many women confused. Dr. Andrea LaCroix, Professor of Epidemiology, Fred Hutchinson Cancer Research Center in Seattle, and Dr. Rowan T. Chlebowski, Professor and Chief, Harbor/UCLA Medical Center, Department of Internal Medicine, Medical Oncology/Hematology, talk about the safety and effectiveness of hormone replacement therapy and try to clarify some of the confusion.  


Dr. Rowan T. Chlebowski and Dr. Andrea LaCroix

Comments [42]

Barbara Lifton from New York City

I am 76 and have been taking a tiny amount of (only) Estrogen every day for 32 years, ever since I had complete removal of all my reproductive organs because of a huge benign tumor in my urterus. Therefore, my body makes NO estrogen naturally.
I cannot live without it, not because of 'menopause', but because without it, my brain would become mush!
My heart, according to a recent Echo-cardigram, is in perfect condition- I have never had cancer, have no problem with my arteries, have very good cholesterol levels, and I have NO problems with my breasts, which have been medically examined once a year or more often since 1979!
Your studies are inaccurate and meaningless, because there are too many variables and too many women out here who have different medical and physical status.
Don't announce results as if they apply to all women, unless you have REAL scientific proof!

Apr. 15 2011 02:07 PM

@Deborah Kaplan East Village - there's an acupressure "viagara point" that's 4 finger-breaths above the ankle bone (inside) for libido/vitality for both sexes. Just hold the point whenever you think of it - this can be done discreetly - it's called Kidney 7, on the kidney meridian.
My father was an OBGYN who also thought is was foolish to mess with mother nature (hormones) back in the 60s (pill) and he was right!

Apr. 15 2011 01:55 PM
Danielle Jensen

any thoughts as to why these hormones are "good" for us when produced by our body but not good when we take them when our bodies are not producing them.

Apr. 15 2011 01:55 PM
mje from New York, New York

I have been diagnosed with early menopause (age 38), and I have started getting night sweats and hot flashes. Can Hormone Replacement Therapy be used to delay the process so that I can have the ability to have a child for at least a couple of years? Is there anything that can be done to treat/delay menopause when it starts at such an early age?

Apr. 15 2011 01:55 PM

My mother took DES.How does thataffect me?

Apr. 15 2011 01:54 PM

Are there currently known risks with late menopause (i.e. over 53 years old)? And is there any dietary advise for those individuals?

Apr. 15 2011 01:53 PM
listener? from nj

I can't stand the audio connection of your guest, Dr. LaCroix. It's so distracting I can't concentrate on the subject!

Apr. 15 2011 01:53 PM
Sadie from upper west sdie

What about Vagifem....I believe it's estradiol. My doctors insist this is so low level hormone replacement that there is very little health risk.
Is this true?

Apr. 15 2011 01:53 PM
Anonyous too

Re: Alzheimer's

Thank you for the response, but now I am confused and alarmed! Dr. LaCroix supports the idea of a woman with early, surgical menopause taking estrogen, and yet she said that it increases the risk of Alzheimer's if taken before 50. Do the benefits outweigh the risks?

Also, I was instructed, because of hereditary cancer risk, to *stop* taking estrogen at age 50. This is the opposite of what Dr. LaCroix seems to be saying to do to reduce dementia risk.
Do I understand her correctly?

(I know you probably won't answer the same poster twice...I understand.)

Apr. 15 2011 01:53 PM
Judy from westchester

I'm disappointed that the doctors were unable to adequately answer the caller's question about pregnant mare urine. It's important that doctors prescribing medications derived from this ill gained substance. The logistics of collecting it involve strictly confining the pregnant horses, usually hobbling them to prevent moving their legs. The foals created as a result of this industry are often killed and sold for meat.
In this age wherein we can synthesize many hormones, there is no justification for this industry and doctors should refuse to prescribe drugs utilizing pregnant mare urine.

Apr. 15 2011 01:52 PM

Can one of the docs answer whether ESTRING (vaginal ring) are useful?

Apr. 15 2011 01:50 PM

Your physician guest may be an expert in his field, but he totally de-credentials himself when he repeatedly refers to the FDA as the "Federal Drug Administration." For the record, there is NO such agency in the USA. It is correctly called the U.S. Food and Drug Administration. :)

Apr. 15 2011 01:50 PM

I understand that all the tests on estrogin plus progestin were done with PremPro. I took them separately (Premarin every day, Provera a few days a month) and don't know whether that has ever been tested. At one time I took PremPro, and it caused me to menstruate twice a month, so I know the two treatments are not the same. Has Premarin plus Provera, as I took them, been tested?

Apr. 15 2011 01:49 PM
JR from NYC

Agree with Deborah in NYC. This is really one-sided opinion.
No comment on the abuse of pregnant mares? No definitive study on the efficacy of bio-identical hormones? Please, do your research guests - this whole interview sounds like a good promotion for synthetic hormone therapy.

Apr. 15 2011 01:48 PM
Patrick from Newark

My grandmother had a hysterectomy in 1963 and was taking replacement medicine for hormones. She had a perforated ulcer and died. My mother said, at the time, this particular medicine was later shown to lodge in the small intestine and dissolve and perforate the small intestine. Can you tell me the name of that medicine?

Apr. 15 2011 01:48 PM

Bio-identical hormones are custom made in compounding pharmacies, which are disappearing. A good info source on this is the group co-founded by Dr. Christiane Northrup in Yarmouth ME - WOmen to Women

Apr. 15 2011 01:45 PM
eleanor from new york

The guests are mentioning relative risk (ex. double the risk for heart... 'although the absolute risk is small') but have not stated what the absolute risks are.

Research publications often stress relative risks because it makes their findings look more interesting, but this is not the most balanced information to present to the public so that they can make informed decisions.

Presenting the relative risk (increase) without the absolute risk (risk of cancer with or without HRT for instance) keeps vital info from the public.

Apr. 15 2011 01:45 PM

Women are going to want to know for better or worse does hrt keep you "more youthful" wrinkles etc ? It's a question women wNt to ask
but feel is too shallow

Apr. 15 2011 01:45 PM
Barbara from NYC

What is Evista and why was I given it instead of estrogen and is it any safer?

Apr. 15 2011 01:44 PM
Cori from NJ

If bioidentical hormones are no better or worse then women should research the deplorable life of progestin horses.

Apr. 15 2011 01:44 PM
Debra Kaplan from East Village

How can hormones be used to treat diminished libido - is testosterone therapy viable?

Apr. 15 2011 01:44 PM
Deborah from nyc

Horses, used in producing premarin, have 7 or 8 estrogen lines that humans do not have.

Apr. 15 2011 01:43 PM
Cori from NJ

After women stop getting rid of blood every month they start to accumulate iron like men do. Do your guests think that the oxidative stress related to the extra iron might contribute to cancers?

Apr. 15 2011 01:42 PM

What about using estrogen only patches with periodical use of progesterone to bring on period so the uterine wall does not thicken. Do any studies relate specifically to this use?

Apr. 15 2011 01:41 PM
MJE from New York

Can Hormone Replacement Therapy or Menopausal Hormone Therapy delay menopause if you are getting hotflashes and nightsweats?

Apr. 15 2011 01:41 PM
Alix from Norwalk, CT

My mother took Fempro for years as a result of the Feminine Forever "cult", possibly 10 years....32
At the age of 70 she developed breast cancer with no family history, etc. Is her use of Fempro a cause here? She was diagnosed very early and went through chemo and is cancer free now.

And on a related topic, I currently take something for dryness: Vagifem: 10MG) what do the doctors think about this practice?

Apr. 15 2011 01:41 PM
donna from brooklyn

here is the link to the nytimes article about estrogen's effect on the brain...

Apr. 15 2011 01:41 PM
donna from brooklyn

here is the link to the nytimes article about estrogen's effect on the brain...

Apr. 15 2011 01:40 PM

@ Mary from Manhattan

I stunned two doctors by reversing my considerable bone loss in less than a year by following guidelines of the Weston Price Foundation - one good book is Eat Fat, Lose Fat - by Mary Enig and Sally Fallon. (Raw Milk for one)

Apr. 15 2011 01:40 PM
Deborah O'Rell from nyc

This is all one-sided information. I believe there is research on the profound difference between bio-identical hormones from an anti-aging perspective.

Apr. 15 2011 01:38 PM
donna from brooklyn

please ask about estrogen-only therapy that starts pre-menopause while a woman is in her 40s and its usefulness for brain fog, prevention of cognitive deterioration, etc.

there was an article in nytimes magazine on this slightly different treatment a few months ago:

Apr. 15 2011 01:38 PM
anonyme again

There are energy approaches to night sweats - Why can't you study women who do yoga for example and their hormone levels?

How about studying Chinese medicine and menopause? ( For example, the fertility numbers are pretty impressive, and trauma free)

Talk about prempro (premarin and provera) and what a mess that made!

Pharmaceutical hormones have been made patentable which means they are no longer bio-identical

Apr. 15 2011 01:36 PM
Stephanie from NYC


Apr. 15 2011 01:34 PM
Carol from Manhattan

My mother was given Premarin following a hysterectomy in the 1980's. She had 3 biopsies for benign lumps in her breasts in the years that follow, and her mood was extreme and erratic throughout my childhood.

Apr. 15 2011 01:34 PM

Oh, good grief. Stop messing with Mother Nautre and embrace your natural changes. There are many natural remedies for the various "symptoms".

Apr. 15 2011 01:33 PM
donna from brooklyn

please ask about estrogen only therapy that starts pre-menopause while a woman is in her 40s and its usefulness for brain fog, prevention of cognitive deterioration, etc. there was an article in nytimes magazine on this slightly different treatment a few months ago.

Apr. 15 2011 01:33 PM
Ken from Soho

The guest mentioned the "Federal Drug Administration". There is no such agency. The two federal agencies regulating drugs are the Food and Drug Administration (FDA), and the Drug Enforcement Administration (DEA).

Apr. 15 2011 01:31 PM
Mary from Manhattan

My doctor tells me must have hormone replacement therapy as I have quite severe osteoporosis. Does this make sense?

Apr. 15 2011 01:30 PM
Anonyous too

I would love to see more studies of HRT on women with the BRCA mutation. Some have had prophylactic oophorectomies and/or mastectomies, and are torn about whether to take HRT if they are relatively young.

Apr. 15 2011 01:28 PM
JR from NYC

Please ask your guests to talk about the difference between bio-identical hormone replacement and the synthetic one promoted by Big Pharma.
Progestin is NOT progesterone and estrogen derived from horse urine is no good, unless you're a horse of course.
I guess it's in the interest of pharmaceutical companies selling synthetic hormones to keep the confusion going.

Apr. 15 2011 01:24 PM
Anonyous too

Why is it that bioidenticals are considered to be more "natural" than horse estrogen?

I'm on estradiol, which is considered a bioidentical (synthesized from plants), but I have heard of other bioidenticals that are mixed by special pharmacies. What is the difference?

Can your guest speak to early, surgical menopause and the risk of dementia later in life? And how HRT might affect this risk?

Thanks for the segment!

Apr. 15 2011 12:36 PM

Bio- identical ESTROGEN and PROGESTERONE are natural hormones - Progestin is fake and a poison, so is horse pee estrogen (which is cruel). Menopause is not a disease. When are we going to see how clunky and dangerous our so-called "health care" system is? I am happy for allopathic medicine when I need the ER for stitches, etc. - but put it next to Chinese medicine for example - especially on the matter of fluctuating hormones - it is just plain crude (and mostly male defined as well.) Your talk with Shirley Maclaine was so divine yesterday - today this? Next time invite someone from Chinese medicine (Dr. Helms of the Helms Institute (which trains 90% of MDs who study Chinese meds) if you want to talk about balance and healing. Guarantee it will be fascinating.

Apr. 15 2011 12:15 PM

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