Is Hormone Replacement Therapy Worth The Risk? | NEW STUDY

In this conversation, Douglas Lucas reviews a study that was released on the risks and benefits of hormone replacement therapy (HRT) for bone health. The study is a 20-year follow-up of the Women's Health Initiative, which enrolled over 161,000 postmenopausal women. The study had two hormone trials: a combined therapy of estrogen and synthetic progesterone, and an estrogen-only therapy for women who had a hysterectomy. The combined therapy showed increased risks of blood clots, stroke, and invasive breast cancer, but also a reduction in hip fractures. The estrogen-only therapy showed a reduction in coronary heart disease, heart attacks, and breast cancer incidence. However, the reduction in hip fractures did not persist over the long term. The study also found no significant difference in risk based on age. The findings suggest that estrogen therapy can be beneficial for bone health, but should be part of a comprehensive approach and individualized based on risk factors.

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This channel is focused on Bones, Hormones, and Healthspan to help midlife women and beyond aim for optimal, not average, and reignite their spark!

The videos on this channel will be focused around helping women navigate healthspan and longevity through the lens of osteoporosis, perimenopause, and menopause. When it comes to osteoporosis and menopause providers and educators often get tunnel vision and your symptoms might get better, but if you don't keep longevity in mind, symptom improvement may come at the expense of heart and brain health.

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Dr. Doug Lucas: Owner/founder of Optimal Bone Health and Optimal Human Health. My team and I work together to create custom bone optimization plans for individuals based around supplements, hormone optimization, peptides and more in order to increase bone health and longevity!

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Watch and Enjoy! Dr. Doug Lucas Key Moments in this Episode
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Chapters

00:00 Introduction and Importance of the Study
08:26 The Impact of the Women's Health Initiative Study
13:36 Understanding the Different Hormone Trials
18:45 The Controversy Surrounding Hormone Replacement Therapy and Breast Cancer
22:06 The Role of Estrogen in Protecting Against Heart Disease
25:22 The Importance of a Comprehensive Approach to Bone Health

[wearelegion]

Thank you so much for what you do! I'm one of those women who got antidepressants & antipsychotics for menopause. That almost destroyed my life. At 66, 9 yrs after menopause & several years after taking myself off all the psych meds, I finally found a doctor to prescribe HRT. I'm against oral medications so use a combo patch & the only problem I've had was breakthrough bleeding after 7 months on patches. I recently had 2 ultrasounds & hysteroscopy & D&C & everything was clear so I'm continuing the patches & dealing with the inconvenience of periods again. The patches help so much with my nighttime symptoms.

[mm-tdxs]

Thanks for your exquisite judgments!❤
I'm 84 yrs old. Was on Premarin for hotflashes for 7 yrs untill I developed migraines and an uncomfortable feeling in my right calf. Have been on BiEst and Bio-identical progesterone for over 20÷ yrs. I'm in general good health except for hypercholestroleamia since menopause and hypothyroidism diagnosed in 2012. Presently, i'm applying all available tools as you so expertly share to keep my osteopenia stable. YOU ARE THE BEST! GOD BLESS!😊❤😊

[lingchinn]

You're channel is the best. The information you give is priceless! You should have so much more followers!

[washima]

Excellent info, so appreciate you Dr Doug!

[petra]

love it, I truly appreciate your info and research

[kimsmart]

Can you please explain how it is that a 24% increase of breast cancer in the original combined study is NOT statistically significant, but a 23% decrease in the 10+ year estrogen-only follow-up IS? 🤔 I know statistics are tricky, but did you perhaps mean clinically significant, based on the raw numbers, in one or both instances?

[jt]

I was never recommended HRT for a variety of health issues that started during perimenopause and persisted during menopause and beyond. I recently went on Estradiol and oral Micronized Progesterone at 60 years old so more than 10 years post menopause.

I initially used transdermal patches but my sensitive skin couldn’t tolerate the adhesive so now I’m using Femring, which is a vaginal estradiol product (0.1 mg) that needs to be replaced every 3 months. Note that Femring provides systemic levels of estrogen unlike vaginal estrogen cream or Estring, which provide localized estrogen therapy to the vagina, so much much lower doses and efficacy.

I am very happy with my improved well being with HRT and wished I would have been offered it years ago when I was only suffering from osteopenia, whereas now I have full blown osteoporosis. Time will tell if estrogen therapy can reverse or prevent worsening of my osteoporosis. 🤞

[anne-louisegoldie]

That's interesting follow-up information, thank you. I'm very glad to hear that the Premarin-only group did well over time with breast cancer statistics.
The thing is, I take micronized progesterone, not Provera, and I use transdermal oestradiol patches, not Premarin. Premarin is made up of many oestrogens, some that aren't found in humans, as well as oestradiol and estrone, plus other molecules.
So the WHI study isn't telling me about the effects of the therapies I'm actually using.
When my doctors tell me, at every HRT appointment, that it causes breast cancer and uterine cancer, I don't think it's data from studies even relating to the prescriptions I'm taking.
There are women still using Provera and there are women still using Premarin, so this should be of special interest to them 😊xx

[quiltbugj]

Total hyst + oopherectomy in 2003 due to increased risk (BRCA + Breast Cancer) - notice the year! Eventually I was able to convince a gyn to Rx vaginal estrogen. I was already on an SSRI - so other symptoms weren´t that problematic.

[charleedell]

It makes me so angry that the significant reduction in osteoporosis fractures endometrial and colorectal cancers shown by the WHI is just never mentioned. It is completely airbrushed out of the equation. As is women's quality of life. The very small risks are generally for conditions that have good treatment outcomes such as breast cancer and are mitigated by a healthy lifestyle eg cardiovascular disease. Many of the women studied were obese, hypertensive, diabetic and smoked. That isn't the referent population I am interested in.

[msplateaugal]

I had estrogen sensitive breast cancer seven years ago and was given a 95% chance of zero recurrence. Would estrogen only treatment be protective for someone like me?

[patriciabrandt]

Dang….i wish you had included testosterone. I’m being told you just cannot increase bone without it and I should have a testosterone pellet inserted. Thoughts about that?

[debraduffy]

I am in my third month of having a pellet injection containing testosterone and progesterone. Progesterone, orally. I’m 71, small frame, osteoporosis (not very advanced). From day one, I have been constipated, I can’t hardly eat solid foods or drink water like I’m used to. My stomach blows up and is hard. I feel like a beached whale. I wear a waist trainer to keep my stomach because I can’t stand myself. I’ve seen a ob/gyn and gastrointestinal doctor and have had a colonic to try to get rid of whatever is blocking me. I have not taken my bone supplements, have not done any exercise of any kind because I feel so blown up. So I feel like I’ve lost 3 months of a bone building regimen. I’m seeing a urologist on Friday. I’ve haven’t had the need for any of the above doctors, EVER. I am not a happy person. I’ll be getting tested again to see if the pellet has totally dissolved so I can throw the progesterone in the garbage. So, this is me NOW!

[adamsxbarber]

I was post menopausal since year 2000 from having a hysterectomy. I was on Premarin and last year at 63 years old I had estrogen positive breast cancer. So I don’t recommend it.

[msplateaugal]

What are your current thoughts about testosterone?

[MariaBrinks]

Can we get through this without using hormone pills?? Can we help our bodies naturally so that we don't have to take these hormones?
I'm still very uncomfortable about the idea of using hormones even if I wanted to I don't think this is something I can afford, can we be healthy and improve our bones without the use of these hormone pills???

[sylvianaylor]

I have used vagifem-ld.. 10MCG ESTRADIOL every 3-4 days. Will this only be beneficial in my uterine tract?