Hormone replacement is back in favor, if it is individualized, given in the appropriate dose, delivery, and timing. HRT appears to protect us in the second half of life even with use of a few years from the start of menopause. I explain and emphasize all this in Safe Hormones, Smart Women. Note my newly-released revised audio edition with over 20 hours of audio. You can get my Safe Hormones, Smart Women in eBook and the audio at the Live Younger Book Store. Click here___.
- The conservative North American Menopause Society in their 9th positional statement says hormone replacement is a good thing when the benefits outweigh the risks, and that estrogen replaced from outside the body may even have protective actions against breast cancer.
- KEEPs study says hormone replacement significantly improves quality of life.
- Danish randomized controlled study shows that hormone replacement significantly reduces the risk of heart disease and continues this protection even some years after you stop taking it.
Hormone studies are now saying that hormones are not only safe again, but also that exogenous estrogen for younger women (50-60 years of age), without the addition of synthetic progestins may, prevent breast cancer, decrease heart disease, and boost the quality of life, preventing or offsetting diabetes, depression, obesity, and sexual dysfunction.
A study called KEEPS, which stands for Kronos Early Estrogen Prevention Study, was presented at the North American Menopause Society in the fall of 2012.
The study focused on quality of life and took a close look at plaque in arteries, cognition, density of breasts and a few other parameters. The KEEPS trial had both groups of women on bioidentical progesterone (Prometrium®, Abbott Laboratories) for 12 days a month, which is called cycling. This is because the progesterone was not given daily, but was given in a pattern to mimic premenopausal women.
The 727 women who were newly menopausal (within three years of the onset of menopause) averaged 52.7 years old. The trial tested two different types of estrogen compared with placebo: a low-dose oral conjugated estrogen and a transdermal (topical) estradiol patch.
The take-home is that the KEEPS trial results showed many favorable effects of hormone therapy.
Women taking hormones had:
- Substantial reduction in menopausal symptoms (hot flashes, night sweats)
- Bone mineral density improvement
- A lowering of bad cholesterol (LDL cholesterol)
- An increase in good cholesterol (HDL cholesterol)
- An increase in triglycerides in the women taking oral estrogen, probably due to its effect on the liver
- Women taking topical estrogen had neither a negative or positive effect on blood fats (cholesterol, triglyceride)
- Topical estrogen had a beneficial effect on insulin resistance
- A trend of less calcification in arteries was seen in women taking estrogen compared with women taking the placebo.
- No negative effect was seen on cognition
- Both forms of estrogen saw improvement in mood and sexual function (Medscape 2012)
The Danish study was a randomized controlled scientific 10-year study, which showed that HRT reduces heart disease by 50% without increasing the risk of breast cancer or stroke.
Emotion has overcome the evidence for hormone replacement!
Danish scientists followed 1,006 women on hormone replacement, 45-58 years old, for 11 years, and even many years later once they went off the replacement.
Women on HRT had less chronic diseases—like heart disease, stroke, heart attack, or bone fractures—and they had better quality of life.
After 10 years of randomized treatment, women receiving hormone replacement therapy early after menopause (before age 60) had a significantly reduced risk of mortality (death from any cause), heart failure, or myocardial infarction, without any increased risk for cancer, blood clots, or stroke.
This article is free on line! British Medical Journal 2012. Go to Pub med and download it.
This study supports the “window-of-opportunity” (starting HRT before age 60, or within 10 years of menopause, and continued for six years or more) for maximal protection against heart disease and overall mortality and minimization of risks.
The authors of this landmark work say that there is a substantial increase in quality-adjusted life-years over a 5 to 30-year period in women who initiate HRT in close proximity to menopause, supporting HRT as a highly cost-effective strategy for improving quality-adjusted life over years to come.