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Clearing the Fog Around Menopause Hormone Therapy

Writer's picture: Dr. Rochelle BernsteinDr. Rochelle Bernstein

A recent review of data from a controversial study reaffirms a consensus among menopause experts: many women benefit more than they risk harm from short-term menopause hormone therapy (MHT).


Published in the Journal of the American Medical Association, this review, based on a 20-year follow-up of Women's Health Initiative (WHI) participants, indicates that MHT offers significant benefits with minimal risks for women in early menopause. It also suggests safety for those in their 60s and 70s experiencing severe symptoms. Crucially, the data shows that MHT does not increase heart attack risk, and short-term use does not elevate breast cancer risk. Recent advancements in product formulations, including lower doses and alternative delivery methods, further reduce potential risks.


However, MHT is not a universal solution and isn't suitable for every woman. Years of mixed messaging have made MHT emblematic of broader issues in women's healthcare beyond reproductive years. The confusion dates back to the abrupt halt of the WHI study in 2002, which led to a drastic reduction in MHT usage, depriving many women of effective treatment for common symptoms like hot flashes, night sweats, and bone loss.


Despite improved understanding of MHT risks, not all healthcare providers have updated their practices. Many women report encountering resistance from doctors unwilling to prescribe MHT. Studies reveal significant gaps in medical education, even among gynecologists, about menopause, as well as a substantial number of women feeling that their symptoms are not taken seriously or adequately treated.


Women deserve accurate, up-to-date information about their health. In today's environment of social media littered with misinformation and some doctors who are inadvertently (or sometimes intentionally) giving inaccurate information, it's no wonder women are frustrated. (A previous blog post debunked some online misinformation about MHT.) The Menopause Society provides a database of healthcare providers who specialize in evidence-based menopause care.


Bottom line: MHT has been proven safe for most menopausal women and evidence supports its safety and efficacy in treating hot flashes and genitourinary symptoms, as well as preventing conditions osteoporosis.



 

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©2022 by Rochelle Bernstein, MD

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