Menopause and Hormone Replacement Therapy

Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses Menopause and Hormone Replacement Therapy.

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Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses Menopause and Hormone Replacement Therapy.
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Featuring Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist Menopause and Hormone Replacement Therapy Duration: 2 minutes, 49 seconds

Hormone replacement therapy has been very controversial. We used to think that hormone replacement therapy universally reduced women’s risk of heart disease.

And until the Women’s Health Initiative study was done, that was the common prevailing belief. But after the Women’s Health Initiative, we realized that hormone replacement therapy can actually cause heart problems.

There are pros and cons to taking hormone therapy. On the one hand, the down side seems to be an increased risk of heart disease, stroke, blood clots, and breast cancer with combination estrogen and progesterone therapy.

The good news is a reduction in colon cancer and a reduction in osteoporotic hip fractures. Looking at the pros and cons, the con side seems a little more compelling. We can treat osteoporosis in different ways other than using hormone therapy. We can screen for colon cancer effectively using colonoscopy and stool testing for blood.

Those diseases can be dealt with in some ways but the heart attack and the breast cancer and the stroke and the blood clotting issues really did curtail the use of hormone therapy in Western society. Before the Women’s Health Initiative, roughly 30% of women were on hormone replacement therapy and now it’s down to around 5%.

Because of the concerns with complications from hormone replacement therapy, yet a demand from women for some way to treat these symptoms, many women have sought out alternative sources of hormone therapy.

The term bioidentical hormone therapy has been put forth. It’s important to note, however, that these hormones are really no different in their effect on the body. It is an unproven idea that one hormone is gonna have a different effect than another, for example, one estrogen versus another.

There’s no good medical study showing that because something is more identical to natural estrogen or natural progesterone that it’s safer. It has not been proven. So, it’s important to discuss all forms of estrogen, all forms of progesterone, all forms of hormonal therapy, with your practitioner.

Presenter: Dr. Richard Bebb