The Facts, Not the Hype, About HRT

by WV Marshall

Engaging in debate about hormone replacement therapy is like watching a tennis game: Swat! HRT is good then Smack! HRT is bad for women.

This volleying is enough to give anyone a headache and leave them confused about HRT’s status.

So, is hormone replacement therapy good or bad?

An opinion piece in the Los Angeles Times makes the compelling argument that yes, HRT is good for women in menopause.

Traditionally, healthcare providers prescribe HRT to women because the therapy is the most effective response to better known menopausal symptoms, such as hot flashes/flushes, night sweats, insomnia, vaginal dryness and diminished libido, as well as some not-so-well-known symptoms such as heart palpitations, bladder troubles and depression, the Times opinion piece said.

But a more convincing case can be made by one of the hormone HRT’s replacing: estrogen. Because estrogen benefits the heart, brain and bones, women on HRT live an average of several years longer than those not taking it, the Times opinion piece said, noting that this is one reason why more than two dozen international groups, including the North American Menopause, concluded that “there are no data to support routine discontinuation (of HRT) in women age 65 years.”

HRT got a bad rep when in 2002, the National Institutes of Health-funded Women’s Health Initiative said women taking HRT ran an increased risk of breast cancer; this was followed by a host of other alleged ill consequences, including heart disease, stroke and dementia.

The rising, panicked tide of bad scenarios drowned the benefits of HRT does.

In the January 2019 opinion piece, the authors ticked off several concerns with the study, including, notably, that the finding that HRT increased the risk of breast cancer was not statistically significant, and that the sample wasn’t representative of either menopausal women or healthy women: The average age was 63, nearly half were current or former smokers, at least a third were treated for high blood pressure and 70 percent had serious weight issues or were obese.

Jill Angelo, founder and CEO of genneve.com, says the Times piece offered her a persuasive claim. She is a “Gen-X woman in perimenopause looking for options on how to maintain my standard of health and well-being as I lean into my mid-forties. And I’m a woman thinking about the second half of life, and with a history of Alzheimer’s in my family, you can bet that I am looking at all the resources available to me.”

In her blog on Genneve.com (an online clinic for menopause), Angelo said Times article’s content elicited this response from genneve.com’s health director and 20-year OB/GYND Rebecca Dunsmoor-Su: “It is nice to see an article that is looking at the health benefits of hormones instead of spreading fear. While I don’t believe that anything (including hormones, of which I am a huge fan) is a miracle drug, I do agree that they don’t deserve the bad rap they have gotten. Hormones (estrogen specifically) can be a healthy choice for many women.”

Angelo said she’s “not unaware” of the remaining risks that surrounding HRT, or alternative options. But, she said, “There is no one-size-fits-all approach to symptom treatment. Every woman needs to be informed and to choose the right path for her.”