A new article in JAMA (September 12, 2017) reverses the outcome of the (2002) WHI study that brought the entire Hormone Replacement Therapy (HRT) field to its knees by reviewing all-cause mortality of the 27,000 women followed for eighteen years who were the original study participants. According to the statistical review by the principal investigators of the 2002 WHI study, the women who were taking hormones (non bioidentical, only Premarin and Provera) did not die earlier or have higher incidence of chronic illnesses than those taking placebo. In fact, because they took hormones, they did better than the women on placebo by improving the quality of their lives, even preventing osteoporosis, heart disease and Alzheimers, increasing sexual satisfaction and eliminating hot flashes and night sweats.
But the medical establishment knew that in the 1960s, 70s, 80s and even 90s. HRT was evidence based state of the art treatment for menopause then. Not giving women HRT would have been considered medically improper then.
In fact, to prove how wonderful HRT was for women, the largest study was started in 1993- The Women’s Health Initiative (WHI). It hailed as a government (NIH) study to be conducted in selected major academic institutions around the US. Huge in size, prospective, double blind placebo controlled, this Cadillac of studies was sure to prove that HRT- only Premarin and Provera- were the fountain of youth for menopausal women.
What wasn’t transparent was the fact that the study was funded by Wyeth and Upjohn pharmaceuticals, the manufacturers of Premarin and Provera, the sole HRT studied. Unfortunately by 2002 the data was not cooperating. It showed increased risk of heart attacks, strokes and even cancer in the women taking the HRT studied.
So the study came to an abrupt halt, received enormous media coverage, scared the NIH and academic institutions into getting off the HRT bandwagon and sadly took down all our faith in hormones while leaving millions of women and their doctors afraid, confused and without hormones.
But that study was grossly flawed.
The 27,000+ women in the study were more than 10 years past menopause. They were older and more likely to get sick or already have heart disease, cancer, strokes and thinning bones. So why didn’t academic medicine and the NIH tell us that until years later? Why did it take the media to discover problems with the study? Follow the money. The NIH and the academic institutions took money from pharma and only studied those drugs paid for and manufactured by the sponsoring pharmaceutical companies. WHI didn’t study all forms of HRT. They omitted human identical or bioidentical hormones that behave completely differently and have decades long track record of safety. When things went wrong with the study all hormone therapies were labeled as bad by the medical societies (ACOG, NAMS). No science supported their statements.
Never mind that. HRT became controversial, gynecologists didn’t want to prescribe them and the traditional medical community went on a campaign to scare women away from HRT. Sadly, not much has changed since.
While study after study in responsible and credible medical journals have shown HRT and specifically bioidentical estradiol and testosterone to be safe and even protecting from heart disease, cancer, osteoporosis and Alzheimer’s and hot flashes to be dangerous harbingers of heart disease, US media and academic centers are mum.
Until last week, when on September 12, 2017 an article in JAMA by the principal investigators of the WHI study who followed the participants in the study for the past 18 years found the women who took the beleaguered hormones didn’t die any faster, sooner, worse deaths than those who took placebo. That is HUGE news!! Finally HRT is vindicated.
Now oddly media coverage hasn’t really done this report justice. It has been casually covered as a ray of hope but not as the wake-up call it MUST be.
While in 2002 the media frenzy killed HRT, the JAMA report was interpreted as light reassurance for HRT. That’s just not right.
As a physician who has been taking care of tens of thousands of women over the past 25 years and treating them and myself with bioidentical hormones, let me give you my takeaways.
The takeaways I share with my patients who don’t live in fear and whose lives are optimized by the support hormones provide.
1. Hormones are great for you. You are better off with any kind of HRT (bioidentical estradiol, testosterone, conjugated equine estrogen, etc.) than nothing. Hormones don’t increase the risk of heart attacks, cancer, osteoporosis and Alzheimer’s.
2. The greatest risk for chronic illnesses including cancer comes from AGEING. With age we lose our hormones. Hormones are our hedge against chronic illnesses.
3. The WHI study was a most horrific insult to women’s health in recent history. It hurt and still does millions of women. Women are suffering because money was more important than pure science and honest medical discourse.
4. The JAMA report from September looked at the same women who supposedly got sick in the WHI study. Theses women 18 years later had same all-cause mortality (reasons for death) as the women who didn’t take the hormones. There is no doubt here. HORMONES DO NOT HARM WOMEN, the medical establishment dogma does.
Take your health into your own hands and learn about hormones, find a doctor who cares and knows hormones and get on them now. Don’t waste another 15 years.