• by Holly L. Thacker, MD
• Director of the Cleveland Clinic Center for Specialized Women’s Health and Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Hormone Therapy’s Comeback

As long as I live, I’ll never forget the date July 10, 2002. That’s when the Women's Health Initiative study was published—and over the following weeks, months, and years, I watched in dismay as a scientific study was distorted into an unscientific sound bite. The message most people took away from the mainstream media was: “Hormone therapy increases your risk of breast cancer, strokes and heart disease.” It was an oversimplification and misleading way to present the data, and naturally, it caused a lot of fear and suspicion. Millions of postmenopausal women stopped taking hormones, an entire generation of doctors began telling women to avoid hormone therapy, and the whole thing resulted in a lot of needless suffering.

Finally, over the last 8-10 years, follow-up research has been emerging to counter the misperceptions. This is a great relief to me because I have always maintained that hormone therapy, when practiced carefully, is quite safe and can be transformational—in particular for women who are in menopause.

Benefits

For women (and men) who are hormone deficient, hormone replacement therapy can be life-changing. Besides helping to improve many of the short-term symptoms of menopause, such as hot flashes, mood swings, vaginal dryness, and sleeplessness, there are other significant health benefits. For example, studies have shown that hormone therapy can:

• Increase elasticity of the blood vessels, allowing them to dilate and let the blood flow more freely throughout the body
• Decrease the incidence of colon cancer
• Decrease the risk of osteoporosis and bone fractures
• Possibly reduce the incidence of Alzheimer’s disease
• Possibly improve glucose levels

• Risks
• As with any kind of medical treatment, there are risks with hormone replacement therapy. For example, it appears to increase the risk of blood clots and gallbladder problems in some people. But for the vast majority, the benefits of a well-managed hormone therapy greatly outweigh the risks.
• Good News, Bad News
• In recent years, largely thanks to breakthroughs in gene therapy, the medical world has moved towards individualization and specialization. Physicians in many speciality areas are now able to customize treatments more than ever before. We’re also seeing this trend in the field of hormone therapy, which is really wonderful news, especially for menopausal women. We have more tools than ever at our disposal to help get just the right dosages and combinations of hormones to help women feel their best.

The not-so-good news is that hormone therapy is not lucrative and it involves a fair amount of education, so it’s not a popular field of medicine to practice. There are 55 million women in the United States in menopause today, and only around 1,000 menopausal experts like myself. So it can be a challenge for people to find a doctor who has the time and expertise to guide them through hormone replacement.

This is one reason I appreciate what Healthnetwork Foundation does. I’ve been seeing lovely referrals from Healthnetwork for about 20 years now. As a physician it’s a privilege to care for people who truly want a focused and comprehensive evaluation and are even willing to travel for the benefit of an un-rushed visit with a specialist. It’s also the reason for my website and podcast, Speaking of Women’s Health. The patients I am able to help in person in my practice are just a drop in the bucket. My mission through my writing and speaking is to educate and empower all women to be strong, be healthy and take charge of their health.

About Healthnetwork Foundation

For more information about anything shared here, please contact Healthnetwork President Megan Frankel at mfrankel@healthnetworkfoundation.org.