Hormone Replacement Therapy For Menopause Is Not "One Size Fits All"
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A recent study found that a specific hormone therapy for menopause that contains estrogen and progestin brings an increased risk of death from breast cancer, but many doctors are pointing to flaws in that research and say there's still an important place for hormone replacement therapy. NY1's Health reporter Kafi Drexel filed the following report. When it comes to hormone replacement therapy for menopausal women, there's one question that always irritates Dr. Steven Goldstein, an OB/GYN at NYU Langone Medical Center and president of the North American Menopause Society.
"People often ask me, 'Are you pro-hormone therapy or anti-hormone therapy?' That's a ridiculous question. You have to individualize, one woman at a time," says Goldstein. "For one woman, it may be totally appropriate to be on hormone therapy. For someone else, it may be totally inappropriate."
A recent follow-up study from the Women's Health Initiative linked hormone replacement (HRT) to an increase in breast cancer fatalities. While it may have created a new surge of fear among some women, Goldstein and many of his colleagues point out the study has its flaws. For one, it only looked at one particular drug, Pfizer's Prempro, and the women in the study were older, in their mid-60s.
"Like anything, it is a risk-benefit analysis. There are risks, there are benefits, but we do not use hormones today in women that age of which was studied in this report," says Goldstein. "We're using hormones today in much younger women who have disruptive symptoms, like hot flashes and night sweats, who can't function during the day, who can't lead a meeting, who need relief."
That was the case for Janet Humphrey, founder of The Giving Nature Center, a women's holistic health clinic, and one of her patients, 54-year-old Bernadette Murphy. Both women decided to pursue HRT, but with bioidentical hormones instead of the pharmaceutical route. Both say the therapy's completely eliminated symptoms.
"I sleep like a baby now, and basically I had about 10 pounds of weight that came on post-menopausal that I couldn't shake, and once I started with the bioidenticals my brain kicked back into its regular gear," says Murphy. "My weight came off and I was happy about that."
"My memory was shot. I couldn't think, as well as some other symptoms -- insomnia, hot flashes," says Humphrey. "And I just wanted to see how it would work for me on a very very small dose that matched my body's chemistry, all of my symptoms were resolved."
Due to some of the linked health risks, doctors do advice women going on HRT to use them for as short a period of time as possible.
There also additional debate about which kinds of therapy are most appropriate. Goldstein's final line of advice is that it is not "one size fits all." Women considering HRT should make sure they undergo a thorough assessment with their doctors.