Post image for Hormone Therapy in Perimenopause: The Truth behind the Women’s Health Initiative Study

In 2002, the now infamous Women’s Health Initiative study sent the medical professionals prescribing hormone replacement therapy for their patients in menopause, into a bona-fide tail spin.  Terrified of putting their patients at risk for coronary heart disease, stroke or breast cancer, physicians abandoned HRT all together, advising their patients to do the same.

Few would argue the value of the study.  The results were crystal clear: hormone replacement therapy put a study group at a 24 percent increased risk of breast cancer, coronary heart disease and stroke.

What wasn’t so crystal clear, however, and unfortunately, which rarely made the nightly news, were other equally important results of the study, along with a few variables which greatly impacted what the over-all results of the study meant.  But, such is the way of the media which always seems to be in search of the next great American health scare, rather than digging deeper to understand the sometimes tedious details and facts.

Synthetic Hormones were the Problem

One very tedious detail and fact is that the hormones which caused the problem were synthetic hormones and not than bio-identical hormones.  This is important, because despite the fact that bio-identical hormones were not used in any of the study groups, many women abandoned all hormone replacement therapy based solely on the results of the study – an unfortunate and proverbial case of throwing the baby out with the bathwater.

What’s more, it wasn’t just synthetic hormones that were the problem either.  It was synthetic progesterone (Provera) which was in question, and more specifically, when it was combined with synthetic estrogen (Premarin) in the form of Prempro, which was the actual problem.

hormonesWhen the women in the study group took Prempro, (both Provera and Premarin combine) they did show an increased risk for breast cancer, coronary heart disease and stroke, no doubt, a legitimate cause for concern.

However, it should also be noted that another group in the study which did not take Prempro, but only Premarin (estrogen), did not show an increase in risk for any of these issues.

In fact, these women actually showed a 61 percent less calcified plaque in their coronary arteries compared to their counterparts who took a placebo after five years, which suggests that estrogen plays an important role in the protection of breast cancer and coronary heart disease.

The Age of the Women in the Study Group was a Significant Factor

Another important variable in the study is that the women who had an increase risk of heart disease, stroke and breast cancer were all over the age of 60.  In contrast, the women who did not show an increase in these risk factors were all under the age of 60.  

While the results of the study were certainly noteworthy, two very important points which are not as widely known, should be made. First, it was the synthetic progesterone, Provera, which actually proved to be the problem, though not by itself.  When Provera was taken with Premarin, a synthetic estrogen (marketed together as Prempro), the women in the study group, all over the age of 60, showed a 24 percent increased risk of breast cancer and heart disease.

However, the women who started taking hormones before the age of 60, and took estrogen without Provera, had no increased risk of breast cancer.  In addition, this same group of women showed 61 percent less calcified plaque of their coronary arteries after five years of using the estrogen, than did their counterparts who took only the placebo.  This suggests strongly that estrogen plays an important role in protecting against heart disease and breast cancer in women.

Second, bio-identical hormones were not used in any of the study groups. This is significant, because there has not been one published study indicating that bio-identical progesterone increases the risk of breast cancer or heart disease.  On the contrary, bio-identical progesterone has to be shown to have anticancer effects.

Finally, despite the foreboding results of the study, most researchers still agree that women should not hesitate to use hormone replacement therapy for treating perimenopause and menopause. However, unless you know the difference between synthetic and bio-identical hormones, you may erroneously think that all hormones will put you at risk for health problems, when this is simply not the case.

What Makes Bio-identical Hormones Different?

Many physicians will tell you that synthetic hormones and bio-identical hormones are exactly the same because they are both created in a lab.  While it is true that bio-identical hormones, like synthetic hormones, are made in a lab, what is not true is that they are exactly the same.  The difference lies in the molecular structure of the hormones.

Bio-identical Hormones are not New

In response to the now known problems with synthetic hormones, modern consumers have been demanding “natural and alternative” treatments for perimenopause and menopause.  But, it might surprise you to know that bio-identical hormones have actually been around for a very long time.

In the late 1930s, early 1940s, a young, physical chemistry graduate student by the name of Russell Marker, devised a way to convert a chemical compound, disogenin, found in Mexican wild yams, into a progesterone with the exact molecular structure of the progesterone produced in a woman’s

What made Marker’s discovery so significant is that prior to this time, progesterone could only be obtained from sows’ ovaries (yes, a pig) or by way of a very complicated and time consuming laboratory procedure which made it very expensive.

With Marker’s method, however, progesterone which looked exactly like the progesterone made in your body, could be produced at a cost of fifty-cents per gram, as opposed to a very hefty cost of eighty dollars per gram via the previous methods.

It wasn’t long, unfortunately, before pharmaceutical companies discovered that this first bio-identical progesterone could be chemically altered to create synthetic variations which, unlike the natural substances found in nature, could be patented.  Since then, the subsequent campaign to sell and market them to physicians and their patients has been fierce and relentless.

How do Bio-identical Hormones Behave in Your Body?

Unlike chemically altered synthetic hormones, bio-identical hormones contain the same molecular structure as those produced naturally by your body.  As a result, your body “recognizes” these hormones and interacts with them in the same way it would interact with the hormones produced in your ovaries – like a key fitting properly in a lock.

Bio-identical hormones are the key which fits perfectly into our body’s hormone receptors, the lock.  Once in place, our bodies shift back into balance and all of those nasty symptoms of hormone imbalance begin to subside.

Synthetic hormones, on the other hand, have chemically altered shapes which are not recognized by your body. Furthermore, they are not metabolized efficiently in the body and interfere with the normal ebb and flow of hormonal function, potentially causing detrimental side effects.

So, while the pharmaceutical companies and some physicians would have you believe that bio-identical hormones are the same as synthetic hormones, they are not. Synthetically produced hormones are not real hormones; they are man-made drugs which wreak havoc in your body.

Bio-Identical Hormones are Safe

But, there is good news. More and more research and studies are being done on the safety and effectiveness of bio-identical hormones.  Though the wheels of progress sometimes turn slowly, the evidence continues to mount in favor of bio-identical hormone therapy, proving they are a safe and effective choice for women seeking relief from perimenopause and menopause symptoms.


Books for Your Perimenopause & Menopause Library

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Getting through perimenopause is an adventure all its own.  Navigating mood swings, hot flashes, and every other cockamamie symptom that seems to come out of nowhere, definitely requires that you eat your Wheaties®. In addition to good health care options, I’m also of the opinion that a good library of books on the subject can be […]

September 14, 2015 CONTINUE READING →

High Doses of Vitamin D do Not Improve Bone Health for Menopausal Women?

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An article posted at Medical News cites a randomized clinical trial study, conducted to test the effects of low-dose Vitamin D supplements versus high-dose supplements in reducing the risks of osteoporosis in post-menopausal women. Other studies have indicated that women in their post-menopausal years (beyond actual menopause) are more susceptible to osteoporosis (thinning of the […]

September 11, 2015 CONTINUE READING →

Dried Plums for Your Bones in Menopause!

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Science Daily  cited a study on plums as medicine for osteoporosis, giving new hope for women who fear becoming dried up, wrinkled prunes in their golden years – sorry, I just had to say it. Researchers from Florida State University and Oklahoma State University conducted a study, funded by the U. S. Department of Agriculture, […]

August 10, 2015 CONTINUE READING →

Are Pelvic Exams Still Necessary for Menopausal Women?

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If you have your ear to the ground in the medical field, then you may have noticed a shift in attitudes among healthcare providers, who are beginning to question the wisdom of routine wellness procedures.  Women’s health is an area which is of particular interest and specifically, routine gynecological pelvic exams for menopausal women who […]

August 5, 2015 CONTINUE READING →

Estrogen, Uterine Polyps & Me

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UPDATE: A reader left a comment pointing out that this article wasn’t entirely accurate.  She herself had undergone a procedure to have uterine polyps removed and informed me that hers were so deeply embedded in her uterus, that there was no possible way for a routine gynecological exam to discover them. She also noted there […]

January 30, 2015 CONTINUE READING →

Children, Menopause & A Mother’s Heart

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  This is a reprint of a post I wrote approximately 3 years ago when I was blogging for Estroven during the Sleep Challenge Campaign.   It was back to school for my newly minted teen daughter this week. After one very busy summer, she packed it in and headed back to the classrooms for […]

January 3, 2015 CONTINUE READING →

Dr. Weil’s Anti-Inflammatory Food Pyramid For Chronic Pain

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If you are a woman in menopause and suffer with generalized achy muscles, bones and joints, unless you’ve been diagnosed with some sort of arthritis, or perhaps even Lupus or MS, chances are the likely culprit is chronic inflammation in the body. Yes, it is true that arthritis, Lupus, and MS cause inflammation. But, there are other […]

April 10, 2014 CONTINUE READING →

Symptoms of Perimenopause Symptoms of Menopause

I thought it would be appropriate – and helpful – to follow up on a recent post I did on the difference between perimenopause and menopause and provide a list of the symptoms associated with each. Though the terms are often (and I’m guilty of the same) used interchangeably, they are not the same thing. Perimenopause is a transitional […]

November 17, 2013 CONTINUE READING →

Perimenopause or Menopause? Get it Right!

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Sometimes I feel like going on a one-woman crusade to change the language we use when we talk about hormone imbalance – i.e.,perimenopause versus menopause. I will admit, I too am guilty of using these two words interchangeably. But the truth is, they are two entirely different experiences, and frankly, should not be discussed as if they are the […]

October 20, 2013 CONTINUE READING →

When Did Menopause Become a “Disease?”

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Menopause as a disease, or as it is often called by feminist scholars, “medicalized menopause” entered the medical lexicon in the 1930s and 1940s. Yes indeed, ladies. What was once thought of as a natural, biological process signaling to women the passage into mid-life, has become a “disease” thanks to one very small group of […]

August 30, 2013 CONTINUE READING →

What’s the Best Exercise for Bone Strength?

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This is not an article I have written.  However, it is an excellent article so I’m posting an excerpt and linking to the actual source at the NYT I’m not a sedentary person. In my 30s and 40s, I was a runner, and for decades, I played singles tennis three or more times a week. […]

August 8, 2013 CONTINUE READING →

Sexuality in Menopause & Post Menopause Years

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There is absolutely no pun intended, but, my last post on loss of libido in menopause turned out to be one very “hot” topic. I posted it on my Facebook page and the ladies went wild. Some of them lamented the loss of their libido while others were just “fine and dandy” with not having sex post-menopause. Personally, as I always […]

July 26, 2013 CONTINUE READING →

Transdermal Bioidentical Estradiol: Defending My Decision

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So, I figured I might have to defend my decision to consider using a transdermal bioidentical estradiol. But, I didn’t think it would happen so quickly. No sooner had I written my post last week, when I received an email (albeit a cheerful one) from a lady who identified herself as a “wellness coach.” She had […]

April 15, 2013 CONTINUE READING →

Menopause: The Ultimate New Year

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Christmas is over and the New Year has finally rolled around again – my favorite part of the holiday season, actually. I see Christmas kind of like Mardi Gras, or bachelor and bachelorette parties.  The great, big, last hurray before you have to knock-off all those shenanigans and begin anew. For Mardi Gras loving Catholics, […]

December 27, 2012 CONTINUE READING →

Fibromyalgia & Menopause: Body Logic Responds

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Continuing with my discussion on fibromyalgia and menopause, I wanted to post the question I presented recently to Body LogicMD regarding the connection between menopause and fibromyalgia. Given that 80 to 95% of all fibromyalgia patients are women, according to the East Tennessee State University researchers, and that a large number of them are also […]

November 28, 2012 CONTINUE READING →

Menopause, Fibromyalgia & Me

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If you read my Healthline column, then you know I was recently diagnosed with fibromyalgia. If you don’t know what fibromyalgia is, well, you’re certainly not the only one. It’s one of those medical catch-all terms physicians use to define a collection of symptoms which can’t be clearly identified with something else like, MS (multiple […]

November 26, 2012 CONTINUE READING →

The Link Between Low Vitamin D & Chronic Pain

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My recent diagnosis of fibromyalgia is still sinking in.  Truth be told, I’m having a tough time embracing it as an “official medical condition” given that it’s loosely defined as a hodgepodge of this and that, with a little “psychiatric” undertones thrown in for good measure. But, make no mistake about it.  The aches and […]

November 18, 2012 CONTINUE READING →

Fibromyalgia & Menopause

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I received a diagnosis of fibromyalgia recently. I saw a Rheumatologist because I was convinced the symptoms which I have been exhibiting the last 18 months were an autoimmune system issue, and pointed to rheumatoid arthritis, aka, RA: nodes in my index finger joint; inflamed joint in my big toe; low grade fevers; debilitating fatigue; […]

November 12, 2012 CONTINUE READING →