Traditional HRT continues to disappoint

     Another big study speaks to what we’ve known for more than 14 years, that failing to use bio-identical progesterone with post-menopausal hormone replacement therapy (HRT) is a risky proposition.  One would think that the medical profession would be getting the message about this, but it’s a slow process. The British medical journal Lancet* recently reported on a long term review of 52 different studies where HRT used either estradiol alone, or estradiol with progestogens.  They found that these regimens were associated with a 40% increase in the two most common types of ovarian cancer.  To keep things in perspective, this translates to one extra ovarian cancer for every 1000 users and one extra ovarian cancer death for every 1700 users. 

     Unfortunately, none of the studies reviewed in the Lancet article used bio-identical progesterone (vs. the synthetic progestogens.  Note that these terms look similar, but are quite different, as this study again demonstrates).  To find perspective, let’s compare the E3N French Women Prospective study, where 53,000 women were followed over an eight year timeframe.  This study did review what most integrative medicine physicians consider to be a preferred therapy, where bio-identical progesterone is used as the balance to the estrogen component.  Six years into this study, the progestogen group also showed a 40% increase in cancer incidence, in that case, for breast cancer.   The progesterone group had a 10% LESS cancer incidence than the same control group, consisting of women who never took hormones after menopause.  In January 2008, with eight years of follow-up, further data from the E3N study showed that women using synthetic HRT had a 60% higher risk of cancer, while women using bioidenticals had the same risk as women using no HRT of any kind.

     The bottom line?  Never take a hormone replacement regimen that includes the synthetic progestogens.  Never, ever.  If you use HRT, find a doctor who uses the bio-identical match for estrogens and progesterone, balances them in combination and individualizes them for you situation.  To find these doctors, either call a local compounding pharmacy for their advice, or look up the doctor locator page for the American College for the Advancement of Medicine, the place where many integrative doctors go to get science based education in complementary healthcare; at  http://acam.site-ym.com/search/custom.asp?id=1758

*“Collaborative Group on Epidemiological Studies of Ovarian Cancer. Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies.” The Lancet, 2015 DOI: 10.1016/S0140-6736(14)61687-1