by Richard M. Foxx, MD
When discussing “hormone replacement,” the most important element is to be clear about the terms that are used. Almost nowhere else in medicine is there such confusion in terms.
The ill-conceived and subsequently discredited Women’s Health Initiative (WHI) study did not employ “estrogen” or “progesterone” as hormone replacement. Rather it used Premarin®, derived from the urine of pregnant mares and containing up to 40 percent horse-specific estrogen (for which we humans have no intrinsic neutralizing enzyme), and medroxyprogesterone acetate, known as Provera®. A synthetic “progestin” rather than true progesterone, Provera possesses a host of unwanted side effects including masculinizing properties.
WHI was not a ”hormone replacement” study, but rather a study that explored replacement of hormones with hormone-mimicking drugs.
Literally millions of women stopped using hormones when the WHI findings were released in 2002. As a substitute, they were offered drugs like Prozac and Zoloft to control their hot flashes and slow the degradation of the quality of their lives.
Now a rehash of the old, flawed analysis has come out and all of the old bogeymen have been resurrected. I expect women will throw their hormones away and run for the hills, or run for Zoloft or Prozac. Trouble is, replacing one drug with another made no sense at all in 2002 and even less now.
An alternative approach is to replace the hormones that are lost in menopause with true natural hormones among which may be estrogen and progesterone. These are also called bio-identical in that they are exactly the same as the hormones produced in human bodies. Non-equine bio-identical estrogen has been virtually exonerated in breast cancer as has natural (bio-identical) progesterone.
Each patient is different, and of course this is not to be construed as medical advice. It is important for women to discuss their own particular situation with their own doctors. It is important, however, to know and to understand there may be safe alternatives out there that will improve the elusive quality of life.
Doctor Foxx is the Founder and Medical Director of The Medical and Skin Spa in Indian Wells, CA, at Hyatt Grand Champions Resort. He may be reached at drfoxx@medicalandskinspa.com or at 760-674-4106