How hormone replacement therapy supports women's health

What you probably already know: It wasn’t that long ago that a study linking hormone replacement therapy (HRT) to breast cancer effectively ended the treatment for millions of women. “Women were literally flushing their hormones down the toilet,” said Dr. Megan Melo, a Seattle-based family and obesity medicine doctor. The study, which came out in 2002, was halted after early data suggested women over 60 were at increased risk of cardiovascular disease, stroke, pulmonary embolism and breast cancer if they took HRT. Now, new studies have shown that, while some women may have an increased risk of developing breast cancer — mostly those who have had it before or have a strong family history of breast cancer — not everyone does. And the benefits of HRT to women’s health can be significant.

Why? “That era has changed,” Melo said at a recent event in Seattle put on by Formidable member Lorrie Baldevia and her company, AssuredPartners. “Hormones don’t cause breast cancer but there’s still a lot of misinformation out there.” Many doctors, for example, don’t have much information to share with their patients about HRT and whether it would be right for them, so women often turn to online experts whose knowledge and backgrounds can be dubious. Many tout supplements and make money off their recommendations.

What it means: Melo suggests women start with their current care team, and if they can’t get the information they need, to turn to physicians who focus on menopause and women’s health. Women now account for 38% of all physicians and the number of OBGYNs — a practice area dominated by women doctors — has grown significantly over the last 20 years. As a result, there is an increased emphasis on the benefits HRT can provide both in the long and short term. It can help with menopause and perimenopause symptoms like hot flashes, heart palpitations and sleep disruption. It has also been shown to protect women from osteoporosis, as estrogen is crucial for maintaining bone density.

What happens now? For women under 55, new studies have shown that women treated with unopposed estrogen hormone therapy, called E-HT, were less likely to develop breast cancer than those who did not receive it. “Gen X is really leading the way for women,” Melo said, “and that includes Gen Xers who are going through menopause, but it also includes medical providers who are saying, ‘you know what? We’re tired of seeing all these women die of hip fractures and heart disease.’ All these things happen when we ignore the option of hormones.”