Menopausal HRT done right is NOT a risky proposition

     A recent review of the hormone literature supports what bio-identical literate doctors have been saying for years, that the bio-identical matches of hormone replacement (estrogen alone, or estrogen and progesterone) do not affect a woman’s risk of dying from any cause, or more specifically, from heart attack, stroke, or cancer. 

     Dr. Khalid Benkhadra, M.D. and his colleagues presented a Mayo Clinic review study on hormone replacement therapy at this week’s annual meeting of The Endocrine Society.  The study combined date from 43 randomized controlled studies on more than 52,000 women aged 50 or older.  This review, called a meta study, gives insights over and above what a single report like the landmark Women’s Initiative Study from the early 2000’s can offer.

     Their findings showed that neither of the main hormone therapies − estrogen alone, or estrogen combined with progesterone − affected a woman’s risk of dying from any cause, or specifically from a heart attack, stroke or cancer.

     Dr. JoAnn Manson, one of the co-authors also noted:  “We really recommend personalizing the hormone therapy decision-making process to the underlying risk factors of each woman,” Manson said, noting that younger women in their 50s and closer to the start of menopause tend to have fewer negative consequences from the therapy. “There’s no one-size-fits-all answer.”

     I couldn’t agree more, although I’d go further to add the following aspects of comprehensive therapy that are often times left out by conventional management options:

-to provide estrogen support that gives a closer match to that produced by a healthy ovary.  This includes the more breast protective estriol that is normally 80% plus of what a functioning ovary makes.

-to prefer non-oral dosing systems such as transdermal application which bypass the gut and liver, providing safer and more efficient therapy.

-to check blood, urine or salivary levels of hormones in replacement therapy to make sure that you have enough hormone support to be beneficial, but not too much of a good thing.

-to consider adding female appropriate testosterone and/or adrenal support as indicated.  These hormones play critical support roles in menopausal aged women and are too often neglected in replacement regimens.

     If your current or prospective hormone support therapy plan does not include these key components, ask your physician, or get a second opinion from a bio-identical hormone proficient physician.  You can find one online by searching the Physician Link Page at The American College for the Advancement of Medicine or by calling a nearby compounding pharmacy for recommendations on local practitioners.

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