Risks & Benefits of Hormones in Menopause
If youíre struggling with menopausal symptoms, you may be grasping for anything that will help you get your mojo back. And chances are, youíll at least consider taking hormones if your menopausal symptoms are severe enough.
I outlined my natural recommendations for treatment of menopausal symptoms here. But what about hormones? Whatís the real skinny?
Back when I was training, we were putting everybody and her great-grandmother on hormones. 90-year-old ladies who had just had a heart attack? Here, take Premarin! 80-year-olds with osteoporosis? How Ďbout some estrogen, hon?! 55-year-olds who had sailed through menopause with ease? Why not take Prempro to protect yourself?
Now we know better. Not only are hormones not cardiac protective the way we once thought — they can actually increase the risk of heart attacks and strokes.
So why would a woman take hormones?
Because they can make a menopausal woman feel great. Hormones can relieve and improve:
- Hot flashes
- Mood swings
- Vaginal dryness
- Brain fog
- Bladder control problems
- Pain or burning during intercourse
- Skin changes associated with menopause
- Helps protect against colon cancer
These are good things, right? So why doesnít everyone take hormones the way they did back when I was in medical school? Because of the landmark Womenís Health Initiative (WHI) study that was terminated prematurely in 2002 when early statistical calculations demonstrated higher death rates in the cohort of women who were taking hormones. Yikes, Batman!
Ever since then, patients and doctors alike have been confused. The data is fuzzy and the truth is hard to sort out, but Iíll try to lay it out for you, ladies.
So what are the real risks and benefits of taking hormones?
In the estrogen/progestin arm of the WHI study:
- There was a 26% increase in breast cancer risk, which means that if 10,000 women were taking hormones for one year, 8 more women would develop breast cancer when compared to 10,000 women not taking hormones. Women in the estrogen only arm did not have a higher risk of breast cancer.
- There was a 29% increase in heart attack risk, which means that if 10,000 women were taking hormones for one year, 7 more women would have a heart attack when compared to 10,000 women not taking hormones.
- There was a 41% increase in stroke risk, which means that if 10,000 women were taking hormones for one year, 8 more women would have a stroke when compared to 10,000 women not taking hormones.
- There was a 37% decrease in colorectal cancer risk, which means that if 10,000 women were taking hormones for one year, 6 fewer cases of colorectal cancer would be seen when compared to 10,000 women not taking hormones.
- There was a 34% decrease in hip fracture risk, which means that if 10,000 women were taking hormones for one year, 5 fewer hip fractures would be seen when compared to 10,000 women not taking hormones.
Itís also important to understand that the WHI study evaluated the use of Premarin and Provera, which are not bioidentical hormones. (Read more about bioidentical hormones here.) No studies have been done to prove that bioidentical hormones are any safer than Premarin and Provera, but it makes sense, intuitively, that your body would respond better and more safely to something it recognizes as your own hormone rather than to something it recognizes as foreign. Although more studies are needed, early data suggests that bioidentical hormones are, indeed, safer. But no study as big as the WHI study has been done.
Why? Because you canít get a patent on a natural substance. And usually, itís Big Pharma thatís funding these big studies, and without their deep pockets, itís hard to get the data. Sadly, we may never truly knowÖbut I hope Iím wrong.
So should you take hormones if you’re suffering?
Itís always good to start with safe, natural options like those described here. But if theyíre just not cutting it for you, talk to your doctor about whether bioidentical hormones might help. Do they have risks? Yes. But life is filled with risk and you canít live in fear. Every time you get in a car you take a risk, but you do it because it improves your quality of life.
Life is short. Itís important to feel vital.
But ultimately, itís totally your call. Check in with your intuition. Ask for Signs from the Universe. Listen to the voice of your Inner Pilot Light. Your internal compass will never steer you wrong.
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Lissa Rankin, MD: Founder of OwningPink.com, Pink Medicine Woman coach, motivational speaker, and author of†Whatís Up Down There? Questions Youíd Only Ask Your Gynecologist If She Was Your Best Friend and Encaustic Art: The Complete Guide To Creating Fine Art With Wax.
Learn more about Lissa Rankin here.