Why the Women’s Health Initiative Study was over-rated and misinterpreted
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The Women’s Health Initiative Study (WHI) 10 years ago was a study that looked at the outcome of women taking congugated equine estrogen and medroxyprogesterone.  It determined that the rates of breast cancer and cardiovascular disease were increased in this group.  After this was released to the public, physicians and societies that give recommendations to patients changed thier views towards hormone replacement therapy in general.  There were several problems with this study and it’s extrapolations to discontinuing hormone therapy in general:

-The estrogen given is not bioidentical human estradiol and estriol, it was estrogen derived from the urine of pregnant mares.  Horse estrogen does not act in the body the same way human estrogen does.  Estradiol has been shown to be protective against cardiovascular disease.  Estriol has also shown to be protective against breast cancer.

-Oral estrogen can increase inflammation and due to a first pass effect with the liver, cause an increase in CRP and fibrinogen which increases the risk of thrombosis.  Topical application of these hormones avoids the first pass effect on the liver and the risk of thrombosis.

-Most of the women who made up the study group in the WHI study were 8 years past the onset of menopause and a large majority of them were smokers.  There appears to be a window of benefit during which hrt can have maximal benefit on women when initiated in the premenopausal period and continued afterwards.

-Medroxyprogesterone (mpa) was used instead of progesterone.  MPA blocks the receptors for progesterone and reverses the benefits of estradiol.

There have unfortunately been many women that have been suffering through menopause and losing protective benefits of hormone therapy due to the misinterpretation of the WHI.  Many studies now back up the claims that Bioidentical Hormone Replacement Therapy is protective against many health issues facing women in premenopause and post menopause.  Bioidentical Hormone Replacement Therapy gives a woman back the original hormones she had in higher amounts before menopause, particularly progesterone, estriol and estradiol.

Contact us for more information of testing for levels at any age if you think you need supplemental doses of hormones.  We can help!

Rothenberg,R, Hart,K.,Rothenberg,R., Hormone Optimization in Preventive/regenerative Medicine Second Ed . Panda Press

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