Are Natural Hormones Better?

Three years ago the world of women’s health turned upside down. That was when a large study, the Women’s Health Initiative, showed that hormone replacement therapy could have serious health consequences.

HRT was expected to protect women from heart attacks and strokes. Instead, it actually increased the risk of cardiovascular complications. The study also confirmed that hormones like estrogen and progestin elevated a woman’s chance of developing breast cancer.

Ever since these alarming results hit the headlines, prescriptions for Premarin and Prempro have plummeted. During the heyday of HRT, almost 80 million prescriptions were filled every year for estrogen or estrogen and progestin products. So far this year, fewer than half that many prescriptions have been filled.

Now women are looking for alternatives. It is estimated that 5,000 American females enter menopause every day. They are experiencing symptoms such as hot flashes, night sweats and vaginal dryness. Many women have questions about what to do: “I am 55 and going through menopause. My physician had me on Premarin for several years. We discussed the advantages and disadvantages of this treatment several times, and he assured me that Premarin helped with bone density and heart attacks as well as other problems associated with the change of life.

“When I heard of the study showing problems with Prempro, he finally agreed that I should stop. I would still like some relief from my uncomfortable symptoms and I asked him about natural hormones. His answer was ‘I don't know anything about that, so I can't give any advice on it.’

“I have gone to this doctor for years and I felt abandoned. I am really suffering with hot flashes, mood swings and trouble sleeping. My physician has no suggestions for me at all.�

Many women like her are looking for alternatives to relieve symptoms without increasing their risk of heart attacks, strokes or breast cancer.

Over the last few years there has been a huge increase in the sales of so-called bio-identical hormones. Compounding pharmacists use soy and yams to formulate estrogen and progesterone that are supposed to mimic the hormones a woman’s own body used to produce. Proponents claim these products are safer.

Despite their popularity, bio-identical hormones are coming under scrutiny. The FDA says that doctors and patients should assume that all hormones have a similar profile of benefits and risks, regardless of how they are made.

Susan Love, MD, a leading advocate for women’s health, points out that high levels of progesterone are not natural after menopause. The American College of Obstetricians and Gynecologists also warns that there is no evidence that long-term use of bio-identical hormones is safe.

For women suffering severe menopausal symptoms, short-term use of female hormones can be helpful. This is still the most effective treatment for hot flashes and night sweats.

We have summarized the pros and cons of hormones in our Guide to Estrogen: Benefits, Risks & Interactions. Anyone who would like a copy may download it from www.peoplespharmacy.com or send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons' The People's Pharmacy®, No. W-49, Durham, NC 27717-2027.