Pro/ Con: Hormone Replacement Therapy

Dr. Mark Winchell on Hormone Replacement Therapy:

“For years, the medical experts believed that Hormone Replacement for women was a good thing. In the process of doing a large randomized, double blinded and controlled study (the only study really good at scientifically verifying data) the evidence was so concerning about the detrimental effects of HRT that the study was abruptly stopped in 2002.  Since that time, the pendulum of knowledge has swung back towards the middle and we now recommend an individualized approach to treatment for women based on the age of onset of menopause and the severity of her symptoms.  The original benefits are still proven to occur, however, there is also mounting evidence of the detrimental issues of increasing risk of endometrial/breast cancer, increased risk of stroke, blood clots and gall bladder disease.  There is also an increased risk of high blood pressure in some patients.  The issues of increased risk are real, but need to be put into perspective. Generally speaking, the risks go up if you are greater than 10 years out from your first symptoms of menopause when starting treatment, are older than 59, or have been on treatment for more than 5 years.  Therefore, starting treatment early in menopause is the smartest way to balance the benefits and the risks, with the plan to stop HRT at the five year mark, if not sooner.  We do not know the long term risks and benefits of HRT and the decision is ultimately between you and your doctor.”


Dr. Mary Kay Ross on HRT:

"When I first started my practice 7 years ago, hormones were very popular, then we went through a period where it became kind of taboo. Through out all of this I have used hormone replacement therapy, always in very low concentrations, though now I have changed my views and use of them.  For women, we now know that we have to be very careful when administering estrogen, so I do a lot of testing that can tell me if someone is able to methylate properly and how they are metabolizing their estrogen. Estrogen metabolism can be linked to prostate and breast cancer as well as blood clots. At the Personalized Institute we use genetic testing as well, to determine the risks better. I like to use bio-identical hormones when I use estrogen and I like to use the lower concentration. I don’t give hormones to everybody; if someone needs to have them we go through the pros and cons and the risks and benefits.  Ultimately, I take Hormone Replacement Therapy as an individualized approach, there are major benefits to hormone therapy but a responsible doctor will watch their patients carefully. It is very dangerous for a general physician that is not trained in hormones to administer them, to both men and women alike. "




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