Hormones got a bad wrap following data from the Women’s Health Initiative or WHI Study, one of the largest clinical trials, over 160,000 subjects in the US looking primarily focused on primary care prevention in women.  The study was conducted in the 90’s and had a hormone-therapy arm that included over twenty-thousand women, ages 50-79, with an average age of 63.

What we learned:

• Hormone Therapy was safest and most effective for younger women, when initiated prior to age 60.
• The types of hormones used, estrogen and progestin, impacted outcomes
• Lastly, timing: initiation, dosing, length of time on therapy, and patient selection were all keys to safe and effective treatment outcomes.

Menopause Society recommends if you are going to initiate menopause hormone therapy (MHT, hormone replacement therapy, hormone therapy) treatment, it should be done within 10 years of menopause, or under the age of 60/65.

And while the WHI trial and its findings certainly changed women’s health, in some cases for the better and worse, some of the data does not apply to the perimenopausal or menopausal women we are seeing and treating today.  Remember, the average age of menopause in the US is 52, with a range from 45 to 58, well below the mean age of 63 noted in the WHI trial.  Also the women of today tend to be more health-focused, not smoking, limited alcohol use and staying mobile, exercising well into maturity.

Subsequent randomized controlled trials have continued to demonstrate favorable safety and effectiveness profiles of hormone therapy when started early in Menopause, and menopause hormone therapy remains the most effective treatment for the relief of vasomotor symptoms, reduced bone loss fracture risk, and prevention of genitourinary syndrome (GSM) of menopause.  While It is not a magic anti-aging therapy, it can have significant positive health effects on so many systems – bone, heart, brain, skin health – and more!

It’s important to understand the short term and Lon haul Menopause journey, and how it impacts your health.  It is important you understand the risks and benefits of available therapies and possible long-term health implications.  So talk to your provider to see if Menopause Hormone Therapy (MHT) is right for you, review benefits vs. risks of taking or not taking MHT, so you can make a well informed decisions.

And it is not just about replacing hormones or or balancing hormones, it it really about optimizing hormone balance for wellness and longevity!  IT is about safety and effectiveness in treating the new menopause woman of today and maintaining mid-life wellness.

So if you are feeling dismissed, don’t be.. advocate for yourself.

Be proactive and know the facts because it can impact your overall health, wellness and longevity!  And YOU deserve better.

References

• Stute P, Marsden J, Salih N, Cagnacci A. Reappraising 21 years of the WHI study: Putting the findings in context for clinical practice. Maturitas. 2023 Aug;174:8-13. doi: 10.1016/j.maturitas.2023.04.271. Epub 2023 May 11. PMID: 37209498.
• NAMS menopause.org 
• “Writing Group for the Women’s Health Initiative Investigators. “Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results from the Women’s Health Initiative Randomized Controlled Trial.” JAMA, 2002; 288(3):321-333.”