Good Women’s Health Estrogen News is Apparently Not News?!?

Good Women’s Health Estrogen News is Apparently Not News?!?

By: Holly L. Thacker, MD • Posted on July 28, 2013

11 Years of Menopausal Hormone Therapy News

Good news should be newsworthy. However, the last 11 years post the Women’s Health Initiative (WHI) has been a constant stream of negative news about menopausal hormone therapy (MHT) and apparently, bad news sells. However, misinformation kills.

Several years ago, the estrogen-only arm of the WHI in women with hysterectomy was released showing:

  • NO increase in breast cancer
  • REDUCED risk of breast cancer for women who took the estrogen tablet daily compared to those on a placebo tablet

That is good news and big news. Furthermore, although the WHI overall showed no change in mortality (death rates) compared to placebo, further analysis of women closer in age to menopause taking MHT showed:

  • REDUCED risk for death and less cardiovascular disease (Cholesterol lowering medicine in women when used for primary prevention does NOT show this benefit)

Further studies, including the KEEPS trial and DOPS (previously reviewed in my blog post, the “Anti-Hormone Party is Over”) continued with very positive news for postmenopausal women who need hormone therapy and for those women who may be hormonally deficient and needing replacement therapy for preventive effects as well as treatment effects.

Nearly, every day in my practice, I see a woman who needs MHT, but is petrified to take prescribed therapy because of the very imbalanced and biased information that has been promulgated, not only by the media but by medical organizations that have been unduly influenced by the WHI and the WHI investigators.

Have You Heard the Latest WHI News?

Last week, a mathematical study was published making the very point that up to 90,000 American women with hysterectomies may have died prematurely because of avoiding estrogen therapy! That’s a big number. So yes, misinformation, fear mongering, exaggerating the risks of MHT and downplaying the benefits has led to a reduced quality of life for many symptomatic menopausal women who have foregone or forsaken therapy - or not even been offered therapy by their equally, misinformed healthcare providers.

It has also potentially cost women their lives in terms of translating to more fractures, higher death rates and consequently a shorter lifespan. Untold misery for symptomatic women and their families has needlessly occurred. That fact, I am absolutely certain of.

Now lest someone (eg, WHI investigator devotee) accuses me of being an ‘estrogen evangelist,’ let me state that NOT all menopausal and postmenopausal women are hormonally deficient. Menopause is a natural life event. So is death. Good health and longevity for women in the post-reproductive years of life is actually bonus years. The following all play a role in determining who best benefits from MHT:

  • Quality of life
  • Quantity of life
  • Symptoms
  • Personal preferences
  • Values
  • Lifestyle
  • Concomitant medical conditions

Fortunately, there are non-hormonal options available for women who cannot or will not use MHT.

Dr. Holly Thacker in the News

I was interviewed by many major news outlets about this recent study and sadly, many news producers, after not being able to back me in a corner to say something negative aboutt his good news, decided not to run the story, or at least not during “prime time.”

Some medical outlets did run the story. You can watch the interview on the Landmark study: Esotrogen saves lives post hysterectomy with author @DrDavidKatz and myself, Dr. Thacker. In professional circles, there has been varying opinions, with the majority of those opinions associated with the (in)famous WHI study. And unfortunately, they are clinging to their negative narrative which is simply not true. Unfortunately, the MHT controversy continues in 2013. Read the NAMS First to Know commentaries, especially Dr. Howard Hodis's clarifying commentary.

Last year, on the 10th anniversary of the WHI, the most respected menopause expert in the world, Dr. Wulf Utian, called for an independent inquiry into the WHI. This past weekend he wrote a superb blog comparing the damage done to women on par with the horrible loss of life in recent US wars in Iraq and Afghanistan. Our @SPKwomenshealth tweet was “Kudos to Dr. @WulfUtian A must read for women and for all those that care about women!"

Be Strong. Be Healthy. Be in Charge!

-Holly L. Thacker, MD

Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Dr. Thacker is also the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause. Her special interests and areas of research include menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health.

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