Estrogen Replacement Therapy Update – The Truth

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BioBalance Health only uses bio-identical estrogen, progesterone, and testosterone in pellet form.

I answer many questions about Estrogen Replacement Therapy ERT every day.  Many of these questions are based on outdated information that women, and even doctors have not updated in the last 30 years.  There has been a lot of research on ERT in the last 2 decades and women need to know the truth! Today I will address all the misinformation that is out there.


First a few definitions of the lingo doctors use when talking about estrogen:

ERT (estrogen replacement therapy) definition is replacing estrogen, in any form, to women who are menopausal and have had a hysterectomy. Women who have had a hysterectomy do not need progesterone because progesterone is given to protect the uterus from PMP bleeding and uterine cancer.

HRT (estrogen and progesterone therapy) definition is replacing estrogen, progesterone, or progestin in any form to women with a uterus.  The progesterone or progestin is given to prevent the uterus from bleeding after menopause and to protect the uterus from uterine cancer.

ET and EPT mean the same as ERT + Testosterone, and EPT is HRT+ T in any form.

At Biobalance Health® we only use bio-identical estrogen and testosterone in pellet form and bioidentical progesterone, no progestins.

What is the difference between progesterone and progestins?

Progesterone is the hormone made by women after ovulation to support the lining of the uterus and a potential embryo.  It is natural and made by the corpus luteum of the ovary.  Progestin on the other hand, is a chemical that was created to balance the estrogens in the birth control pill and oral menopausal medications. Progestins have many side effects and contribute the complications that many women get from oral hormones. Natural progesterone in all forms have very few side effects and protect the uterus from developing uterine cancer.

How long can I take Estrogen? Don’t stop! The reason women are so confused is that the College of OBGYN placed arbitrary limits on how many years a woman can take the form of estrogen they prescribe—oral synthetic estrogen and progestin…..and they keep moving the limit.  The current limit of  how long a woman can take estrogen is arbitrary and not based on non-oral estradiol replacement but guesses and small studies they do on oral estrogen and progestin. They view ERT and HRT both as a one size fits all and it can’t be farther from the truth!

Does estrogen cause breast cancer? No estradiol DOESN’T cause breast cancer.  Your biggest risks of developing breast cancer are obesity, large intake of simple sugars, insulin resistance, Type II diabetes, alcohol intake and lack of exercise.  Estrogen has been circulating through your body for decades and estrogen doesn’t cause breast cells to change into cancer cells.

There are some cancers of the breast (ER receptor + breast cancers) that are stimulated to grow by estrogens, and we don’t give estradiol to women who have had these breast cancers unless they have had a double mastectomy and did not have positive nodes.

Estrogen DOES and can cause uterine lining cancer (not ovarian cancer) called endometrial cancer. We give women with a uterus progesterone to take with their estradiol pellets to counteract the stimulation of the endometrial cells into cancer.  We require our patients to take progesterone (bio-identical) to protect them from any danger from uterine cancer. 

Does Estrogen cause blood clots?

Oral estrogen can cause a woman to be more likely to get a blood clot. Oral estrogen circulates through the liver first thing before it is circulated through the body and in that way stimulates the production of fibrinogen and other subsets of blood clots to start the “ball rolling”. However, non-oral estrogen (pellets, patches, creams, gels, sublingual tablets, and vaginal tablets) does not have the same effect.  There are many studies in the last 20 years that substantiate this fact, but most doctors have not gotten the message and still advise women who have had a blood clot not to take any estrogen of any kind!  They are wrong.

What does estrogen replacement do for me?

  • Estrogen keeps women young both physiologically and physically
  • Estrogen prevents osteoporosis
  • Estrogen prevents the vagina from shrinking, prevents it from atrophy (drying out)
  • Estrogen maintains the bladder and prevents incontinence and bladder infections
  • Estrogen prevents painful intercourse after menopause
  • Estrogen keeps a woman’s skin soft and her hair growing normally
  • Estrogen prevents hot flashes and night sweats
  • Estrogen prevents insomnia
  • Estrogen prevents heart disease
  • Estrogen maintains the immune system
  • Estrogen prevents Alzheimer’s disease and dementia


Why did the physician groups stop estrogen replacement therapy to women?

They reacted to the WHI study with an emotional response before they even read the study and determined whether it was true or not!  The doctor’s leadership are so afraid of lawsuits they immediately recommended taking all women off estrogen and not restarting.  Meanwhile woman all over the country were in physical and emotional pain from their lack of estrogen.  Most of the doctors never read the WHI study, but I did!  It did show that PROGESTINs do increase the rate of breast cancer and heart disease, but not progesterone.  They didn’t even study progesterone until later when it was proven safe.

Progestins also increase the risk of heart attacks in women, but estrogen taken without progestins were safer than taking NOTHING!

Let me recap: The WHI study has been proven wrong.  It said that E2 was dangerous and caused breast cancer and heart disease.  It was misinterpreted and the cause of breast cancer and heart disease was finally found to be the progestin (not progesterone) that was used for HRT in the study.  The women who only took estradiol because they had a hysterectomy had a lower rate of breast cancer and heart disease than those women who took HRT and who took nothing!

So, what do you do If your doctor doesn’t “believe in” estrogen replacement?

Find a new doctor!  Don’t listen to old, false information repeated by your doctor.  You know what you need.  Women are very astute at self-diagnosis and after menopause to feel better we need estrogen!

  • Find a doctor to give you non-oral estradiol with or without natural progesterone because this decision can literally save your life!

At BioBalance Health we replace estradiol in the safest way to keep women healthy, safe, and without the diseases of aging.  In women with non-estrogen receptor positive breast cancer, we offer estradiol with testosterone in non-oral long acting pellet therapy. You can live well and healthy as you age!

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author. 993-0963.

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