The Beginning of Hormone Replacement Therapy
You might be interested in a short history of HRT as background to all the other articles about hormone therapy.
When hormone replacement with estrogen started, doctors noticed (or where told by their patients) that the women felt happier and looked younger and healthier. This trend led to the idea to promote HRT as a preventive therapy for aging women.
After several years of prescribing estrogen, reports came out aboutincreased endometrial cancer in women who still had a uterus. So progesterone, mostly in the synthetic form Progestin, was added to prevent the build up of the uterine lining.
Aside from the youthful look and treatment of menopause symptoms, estrogen therapy or HRT was thought to prevent not only heart disease, but dementia, osteoporosis and colon cancer.
Unexpected Hormone Therapy Risks
Years went by and more and more warnings from doctors began to emerge about risks and side effects of HRT. To test the validity of the original theory that HRT should prevent these diseases, a long term study was launched in 1991, called the Women’s Health Initiative. It is still the largest long-term study about hormone therapy.
In 2002 the estrogen -progestin (women using Prempro) part of the study was abruptly stopped when data showed that contrary to the original assumptions, HRT increased breast cancer, strokes and heart disease/heart attacks.
Ever since this time, researchers are going through the data and history of HRT with a fine tooth comb and ever smaller slices of data are analyzed.
Current Status and Conclusion about
the History of HRT
You will still hear reports about the newest findings based on the data from the Women’s Health Initiative, despite numerous flaws regarding the design of the study. There is also critisism regarding the specific hormone therapy that was used: Conjugated estrogen: Premarin for women who had a Hysterectomy and Progestin: Prempro for women who still had a uterus.
There are many books written about the subject and many of the popular menopause books have at least a chapter about the History of HRT and the Women’s Health Initiative. Many of those are very biased toward one position or another.
Our bias is clear: The Women’s Health Initiative was a very important study that opend our eyes toward the potential risks of using hormones. It also started the discussion about the pro’s and con’s regading the specific hormones that were used in the study. Ultimately this led to the development of better treatments and treatment recommendations.
Understanding the background of Hormone Replacement Therapy for Menopause still doesn’t answer the question: “Should I use hormones for my symptoms? Or are they too dangerous?” Modern medicine still can’t give us a clear and easy answer to this question. So what should you do?
First and foremost: Find a good gynecologist that understands your concerns and is up to date on the issue. (The link will take you to the American Menopause Society – Menopause Clinician Database. It will open in a new window.)
Our recommendation: Start with the least invasive option that will help your symptoms, such as a herbal remedy and / or lifestyle options. If any of these don’t work and your hot flashes are driving your crazy, consider hormone therapy preferably using natural hormones.
Now that you have a little bit of background about HRT, check out the other articles about hormone therapy.