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Hormone Replacement Therapy, Yes or No?

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I know a lot about hormone replacement therapy. Eleven years ago I was diagnosed with estrogen positive (ER+) breast cancer, which means my cancer was fueled by estrogen. Before I started 1010ParkPlace, I had a Top 10 Breast Cancer Blog and the only Survivorship resource for families. Wearing my journalist hat, I interviewed world leaders in breast cancer research and was tutored by experts like Dr. Susan Love, who just updated the 6th edition of her “Breast Book,” the definitive, well-respected “bible” on breast cancer. I learned as much as a layperson can about genetic links, possible causes and ways of reducing the risk of recurrence, or getting breast cancer in the first place. I’ve spoken at women’s health conferences and moderated breast health panels. Even so, before writing this post, I researched the current thinking regarding hormone replacement therapy (HRT).

I tell you this because I want you to know I’m not new to the HRT conversation.

For decades HRT was the gold standard used to treat women going through menopause. Two years ago the Journal of the American Medical Association published the “Women’s Health Initiative” (WHI), which changed popular thinking about HRT. The study reported no net HRT health benefits and some net harm. As a result, HRT is no longer routinely recommended. That said, new evidence shows systemic hormone therapy (pill, patch, gel, cream or spray) may be a good choice for some women, depending on their risk factors: the age they started taking HRT; their current age; the type of HRT; whether they’ve had a hysterectomy, or if they have a family or personal history of cancer. As you can see, it’s complicated.

Because I don’t want you to miss any of the nuances associated with these studies, if this is a topic of interest to you, I want you to read, for yourself, what the Mayo Clinic has to say as well as Dr. David Katz, Director, Yale University Prevention Research Center.

I will say, if you’ve been diagnosed with ER+ breast cancer; you carry one of the breast cancer genes, or have a family history of breast or uterine cancer, you should stay away from all forms of estrogen. This includes HRT, foods containing phytoestrogens (which convert to estrogen in your body), or beauty products containing parabens, which also convert to estrogen in your body. You should also stay away from all soy products… another complicated conversation.

While many doctors are not giving out good advice about HRT, neither is Suzanne Sommers. In 2011, I appeared on The Today Show with Dr. Nancy Snyderman to talk about bioidentical hormones, something Ms. Sommers has written and spoken about extensively.

As Dr. Snyderman said, “Your body doesn’t know the difference between bioidentical hormones made for you by a compounding pharmacist (yet another complicated conversation), or hormones that come from a pharmaceutical company. Hormones are hormones.” Bioidenticals have the same risks as synthetic HRT, plus they are often made from soy.

For those of you who think bioidentical hormones are better for you, you might want to take all of this information into consideration.

Love, Brenda

17 Comments

  • Kay Lynn December 12, 2015 at 8:40 am

    HRT is complicated and every woman (with advice from her physican) has to decide for herself when to take take them and when or if to stop.

    • 1010 Park Place December 13, 2015 at 2:33 pm

      It’s not only complicated, but there are other issues no one’s mentioned, yet, like women who’ve taken fertility hormones…. There are reasons why Mother Nature doesn’t want us to have estrogen after a certain age, or we would have it coursing through our bodies until we’re 100!

      • mamavalveeta03 December 14, 2015 at 8:34 pm

        My mom took HRT forever, too, until I questioned the wisdom of her staying on it. She went off and immediately began having hot flashes, but fortunately, her bone density is good at age 76. I took Clomid before becoming pregnant with my first daughter until it made my left ovary blow up like a balloon ( interestingly enough, the ovary that I had removed 10 years ago!). I’m conscious of my health and think it’s important for us to be proactive with physicians.

  • cathy December 12, 2015 at 8:43 am

    thank you for sharing this information, brenda! even though my breast cancer was triple negative, my oncologist will not let me take hormone replacement. my mom has been on hormone replacement for over 30 years. i swear it keeps your skin looking better! wish there was something i could take! i just wanted to thank you for sharing this information to your readers! knowledge is power!!!

    • 1010 Park Place December 13, 2015 at 2:35 pm

      Your mom’s been taking HRT for over 30 years? Wow! Let’s hope everything continues to go well for her. Estrogen is the fountain of youth, from head to toe, that’s for sure! I think your oncologist is smart.

  • bestill December 12, 2015 at 9:05 am

    Totally agree, Brenda! Thank you for posting! Sharing.

    • 1010 Park Place December 13, 2015 at 2:36 pm

      You’re welcome!

  • Katy Kozee December 12, 2015 at 9:06 am

    We need to talk more about HRT – there is so much misinformation. I know there are women for whom it is an absolute no, but I think there are too many other women suffering needlessly because of bad advice. Thanks for a balanced piece.

    • 1010 Park Place December 13, 2015 at 2:37 pm

      There are so many pros and cons. It’s not a one size fits all issue, so it’s something every woman and her physician needs to carefully review. Even if you’re a candidate for estrogen, it’s not a forever thing or we would naturally have it until the day we die.

  • mamavalveeta03 December 12, 2015 at 3:55 pm

    Thank you for such important information for women of our age, Brenda. I’m fortunate that most of my symptoms are quite mild, such as overheating, brain fog at times, minimal hair loss and probably mood swings (How do I know if my husband is afraid of me?!? 😉 )

    What are the reasons to go on HRT if not for control of menopausal symptoms? Osteoporosis prevention? Because there are other medications that can take care of that, right?

    • 1010 Park Place December 13, 2015 at 2:41 pm

      Initially doctors thought HRT was good to prevent heart disease, but that’s not necessarily the case. Osteoporosis… I take Boniva, Calcium and 50,000 units of Vitamin D once a week, prescribed by an Endocrinologist, who monitors my calcium with blood tests and bone scans.

      • mamavalveeta03 December 14, 2015 at 8:26 pm

        So far, so good on the bone density. But my Gyno recommended that I take a vitamin D supplement, which I do. Thx for the info, Brenda.

  • Leanne@crestingthehill December 12, 2015 at 11:10 pm

    it’s always good to have as much information as possible in this area – I haven’t gone down the HRT path yet but the more I read, the more reluctant I am becoming in regard to the whole thing.

    • 1010 Park Place December 13, 2015 at 2:42 pm

      Leanne,
      From what I know, if there’s a way you can live without HRT, you might want to consider that. I’ll say this again, but there’s a reason why we don’t have estrogen coursing through our bodies until we’re 100! It’s my opinion that Mother Nature knows best.

  • Jennifer Connolly December 13, 2015 at 12:44 pm

    Thanks for this great information Brenda! My doctor won’t put me on HRT because my Mom had breast cancer. I could sure use some for the menopause symptoms. And my bone health!

    • 1010 Park Place December 13, 2015 at 2:45 pm

      Smart move that you’re not taking HRT. I mentioned below that I take Boniva (monthly), Calcium and 50,000 units of Vitamin D (once a week), prescribed by an Endocrinologist, who monitors my calcium with blood tests and bone scans. Because of your recent problems, I hope someone is getting you on a plan to monitor you closely and longterm. You’ve started walking, so that’s a great thing.

      • Jennifer Connolly December 13, 2015 at 4:14 pm

        I’m going to ask about Boniva because with my bad hip I can’t walk too far. Not until I get it replaced!

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