Hormone Replacement Therapy and Breast Cancer: A 24-Year Debate
According to a 24-year-old study, hormone replacement therapy can lead to breast cancer. Was the study inaccurate? Medical professionals have been debating that point ever since. By Sarah Rose
Background: The WHI Controversy
In 2001, the Women’s Health Initiative published a study suggesting that hormone replacement therapy causes breast cancer. Since then, the medical community has been debating the risks versus the rewards of the treatment for women in perimenopause and menopause. Dr. Edmund Rhett, board-certified OB-GYN and founder of Rhett Women’s Center, explained that “The study was inaccurate. Actual data showed that Provera, a form of the hormone progesterone, increased the risk by 20%, while estrogen use decreased breast cancer risk by 20%. But that didn’t make the headlines and the misinformation became widely accepted as fact.” “The confusion usually lies between real progesterone and synthetic versions like medroxyprogesterone acetate, which do increase breast cancer risk,” he said. “However, studies show that women on bioidentical estrogen and progesterone have a lower risk of breast cancer compared to women not on hormones at all.”
When Symptoms Begin and Why
Dr. Rhett, who has specialized in hormone replacement therapy for over two decades, explained how and when symptoms of perimenopause and menopause begin to manifest. “Perimenopause usually starts in a woman’s late 30s due to a decline in progesterone. That creates estrogen dominance, which leads to what I call the five evil Bs. These are bleeding, bloating, breaking out, breast pain and feeling blah. As time goes on, they may also lose adrenal hormones or testosterone. Eventually, menopause sets in when the ovaries stop producing estrogen, typically around age 50 or 51.” He added, “Now we know that patients using bioidentical hormones, the same hormones their bodies naturally produced at age 27, respond extremely well. Our patients go from feeling awful and old to young and spry. Balanced hormones help them sleep, feel better and become more active. Overall, replacing progesterone makes women feel human again, and everyone in the house is happier.”
Treatment Options and Care Plan
Delivery methods for HRT include pills, creams, subcutaneous pellets or sublingual troches. “Most patients prefer pellets because they last about three months,” Dr. Rhett said. Ideally, patients will stay on bioidentical hormones for life unless they develop a condition like breast cancer, in which case the treatment will stop. “The process depends on the patient,” he continued. “For a 55-year-old who hasn’t had a period in three years, we measure levels and start treatment. For someone younger with symptoms, we definitely do blood work first to guide dosing. Our compounding pharmacy then creates the mix we prescribe. We track lab results and symptoms to adjust as needed. If they feel great, we stick with the plan.” Unfortunately, he said, insurance usually doesn’t cover bioidentical hormones.
Another Expert’s View
Dr. Kenosha Gleaton, founder and CEO of EpiCentre and a board-certified OB-GYN, is also an advocate for HRT. “The imprecise data issued by the study created fear-based propaganda. Doctors told women to throw hormones away and flush them down the toilet,” she explained. “But the truth is that the treatment is safe and it can also be life-changing.”
Patient Demand and Symptom Range
Of the 35 to 40 patients Dr. Gleaton sees per day, approximately 22 to 25 ask about having their hormones checked. “To me, that means a woman knows when there’s something off in her body,” she said. “Whether it’s a seemingly random issue such as allergies, ringing in the ears, vision changes, joint or bone pain, immobility, insomnia, brain fog or weight gain, the challenge can be a result of estrogen deficiencies. So can other symptoms such as low sex function, lack of sensation or pain during intercourse, which can lead to low libido or lack of interest, causing marital drama, anxiety and depression.”
Re-educating the Public on HRT Benefits
She added, “Because women spend one-third of their lifetime in perimenopause and menopause, the public needs to be re-educated about the benefits of HRT. Estrogen can keep tissue safe, restore female vitality and libido, protect bones and reduce the chance of colon cancer. The treatment is also cardio-protective, which is important since heart disease is the number one killer of women in America. One in three will die of cardiovascular issues.” “Life is too short, and it’s not necessary to suffer through this change in silence,” she said. For those who are still skeptical, Dr. Gleaton advised double-checking the data and verifying their sources of information. Otherwise, the case is closed.
By Sarah Rose
