Do we focus more on the risk or benefits of Hormone Replacement Therapy?
We recently attended a Medical Conference at the 2017 AMMG conference in Tucson, Az. While there we participated in a discussion presented by Dr. Gary Donovitz who posed the question, “Do we focus more on the risk or benefits of Hormone Replacement Therapy?”
We find this to be an interesting question because it raises the issue of whether or not the medical system in the United States is predisposed to focus on the possibility of a negative impact or symptom arising out of a treatment or do we focus more on positives that we know when considering treatment plans? Part of the discussion can relate to the practice of the FDA in limiting the use of some treatments or medicines because of the claims made regarding negative outcomes or reactions when those treatments are used. How much is too much? If there are some negative outcomes, do those outweigh the known outcomes or the potential for positive outcomes? Who can or should make the treatment decision, The Governmental regulatory authority or the physician and the informed patient?
We know that sometimes people and their physicians avoid treatments because they are not known as “standard of care” or the regulations do not list the treatment as approved. We also know that many if not all physicians utilize treatments that are “off label”. This is not illegal, just not stamped with a seal of approval by the FDA. A doctor and patient can legally make the decision to utilize a treatment in this way. It may not be approved by the feds or by the insurance provider, but it may still be something you want to consider.
This week we are presenting in our healthcast a discussion of these points of view. Three recently released studies contradict what has been the conventional wisdom among physicians over the last dozen years. Let’s look at what they say:
A Mayo Clinic Study combining data from 43 randomized trials of 52,000 women over 50 which looked into HRT use, and found that: “estrogen alone, or estrogen combined with progesterone did not affect a woman’s risk of dying from any cause or specifically from a heart attack, stroke, or cancer.”
Sarrel P et al. “The Mortality Toll of Estrogen Avoidance” in the Am J of Pub Health 2013. Over a 10-year period starting in 2002 between 18,000 and 91,000 women died prematurely because they had not taken estrogen replacement treatments. Joann Manson in September 2017 Jama Article states, that if women took estrogen replacement with or without premarin/provera for 5 to 7 years, there was no data to show an increase in cause mortality, especially cancer during an 18 year follow up period.
Dr. Donovitz’s presentation identified common complaints as hormone levels drop: They are; low energy/ mood swings/ weight gain/ joint pain/ difficulty sleeping/brain fog/ low sex drive/ risk of age related diseases. He identified the benefits of optimized HRT as: energy increase, better sleep, better mental clarity, increased ability to lose weight, increased sex drive, and breast-bone and heart protection
Dr. Donovitz identified typical questions women will ask about HRT, those are:
- Heart attack?
- Blood clots?
- Hair loss?
As you can see, the examination of HRT is alive and well in the medical communities and doctors are still trying to learn what works best for most people as they age. The jury is still out and patients should discuss these studies with their physicians as decisions about their health care are being made.
This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.