Hormone Therapy for Menopause Remains at Historic "Lows" Despite "Effectiveness" and "Safety" Profile - Medscape Sept. 2024

Get with the hormone happening!

Hormone therapies started in England in the mid 1900’s.

Toward the 2000’s about 18 to 20 million American women were on estrogen and other hormone therapies. To stay younger. To help heal heart tissue after a nasty event, like a heart attack, or even the placement of a stent.

Women looked younger longer. Felt better. Aged slower.

But then the Women’s Health Initiative, two small randomized trials that soon proved wrong, stated hormones caused the issues that we thought they helped prevent.

We are a reactive country.

Based on these two small trials (later found to have lots of methodological issues which continue to mount) American docs stopped writing scripts. Lawyers sued. Women feared estrogen more than cigarettes.

Now with the final re-analysis of the Women’s Health Initiative by the original authors and the 10 Million Study by our own NIH and the fact that aging folks on hormones need less meds and live younger longer, estrogen and hormonal therapies are finally vindicated.

But alas, we are so fast to change paths and opinions and angers and listen to supposed experts, hormonal therapies just didn’t stop being prescribed. They stopped being taught.

Menopausal and andropausal medicine in all schools - medical, osteopathic and even naturopathic - we have learned that hormones are to be feared. Not taught.

Instead, have your patients take drugs and more drugs… for your bones, drugs for your heart, drugs for your kidneys, drugs for your brain.

We have American women on conveyor belts of meds. (Docs have helped make women more “comfy” with meds, than with the thought of natural estrogen)

Yet often, if on balanced hormones, women (as well as gents) need much, much less meds, and feel much, much better. Let alone look better. For much longer.

But now, in America, we don’t have providers, at least enough, that know how to use hormones in practice.

Today, less than 4% of American women aged 50-59 years use hormone therapies.

In September 17th the VERY conservative Medscape online journal, that goes out to over 8 million providers worldwide, even says that it was the Women's Health Initiative (WHI) study that misguidedly cast doubt on the safety of hormones. Putting a huge black cloud over estrogen.

Subsequent research and our hormone course that Dr. Brownstein and I put together, Everything Hormones, have addressed the flaws of the WHI study. (It’s 16 CME hrs. for MDs, NPs, etc. online with 11 hrs of non CME and many helpful clinical course materials. You learn about bases, delivery modes, dosing, and even how to reboot fertility in young males with low T irresponsibly given T replacement as many docs don’t realize what they are doing).

There is now huge support for the use of hormones, including estrogen, in most menopausal women.

But the use of this therapy has never recovered!

These horrific facts were presented at The Menopause Society 2024 Annual Meeting in Chicago on September 12.

"Despite evidence supporting the efficacy and safety of hormone therapies, usage rates… remain low," said Stephanie Faubion, MD, MBA, director of the Mayo Clinic Women's Health in Jacksonville, Florida, and medical director of The Menopause Society, told attendees.

"Improved education of clinicians and patients is critically needed."

The lack of education among providers is likely the biggest reason for the decline, this Medscape article goes on to say.

"I think it's because there's a whole group of providers that did not receive any training, and that's OB/GYNs, internal medicine, family practice, endocrinologists," she said.

If you ask these docs about hormones… they do NOT know!

Also, in med schools, doctors are not trained to think agilely.

They are told what to think. (Often by Big Pharma backed curriculum that guides them to mainly prescribe drugs, as most med schools get their monies from these guys).

Think this or that. Use this or that drug.

We have docs that do NOT know about hormones.

Do not “think” about hormones.

Do not know about root cause.

Also, it’s human to be DOWN on what one is not UP on.

Grok this.

Though 40% of the women said their provider attributed their symptoms to perimenopause or menopause on the second or third visit, 18% saw a provider 4-5 times, and 17% saw a provider more than five times before the provider considered menopause as a cause.

About a third of the women (35%) brought it up to their doctor themselves and found their provider receptive, but 40% said the response was dismissive when they brought it up, and 15% said the topic was never broached at all.

Why? These docs were “dismissive” as they “don’t” know hormones.

I asked my amazing internist whom I adore, as I need a doc with hospital privileges just to be safe if I need a hospital in the future, to run some hormone tests for me.

She was head of her class in med school. Everyone knows how smart (and kind) she is.

I said let’s also run estrone.

She looked up at me from her computer, I kid you not, and she said:

“What’s that?

How do you spell that?

Ugh.

Andrea Donsky, RHN, founder of Morphus who conducted the study showing the sad hormone clinical state of affairs, told Medscape Medical News:

"A lot of women spend years not knowing they're in this phase of life, so they visit their doctors/HCPs [healthcare providers] many times because the connection isn't made on the first visit."

Danielle Meitiv, MS, a study co-author and health coach based in Silver Spring, Maryland, added,

"Everyone wonders why we end up with Dr Google; that's the only doctor who's talking to us about menopause."

Pinkerton was less surprised by these survey findings.

"As a menopause specialist, my most common new patient is a perimenopausal woman who feels like she hasn't been listened to," whether it's her primary care doctor, her OB/GYN, or another clinician”.

Now medical publications like Medscape are even saying, putting in their title of a different article that came out a week earlier, Hormone Therapy Can Benefit Women Into Their 80s!!!

This article ended with:

"It is reassuring that women who choose to extend hormone therapy (throughout life, Berkson) can safely do so.

“It is irresponsible, cruel, and nonsensical to continue to make blanket statements that hormone therapy should be discontinued based on age or years of use and commit women to enduring symptoms and depriving them of possible long-term benefits."

I have been saying this for years.

Many functional docs have been saying this for years.

Not all.

Naturopaths used to say this. But then they overlapped with the medical mindset. (Though some NDs are superb hormone docs! Many of them are my dear friends!)

Urge your providers to take Everything Hormones and be “up” on what most are “down”on. Wrongly so.

We invite all providers and even any interested women that just want to know the facts to attend. The course is up online Evergreen.

Dr. Brownstein and I are considering an in-person course in Chicago this late spring or fall. Anyone interested?

Knowledge is definitively power, and helps us all live younger, longer.

Here is a small eBook that explains estrogen’s vindication, if interested.

Dr. B.

References:

Hormone Therapy for Menopause Remains at Historic Lows Despite Effectiveness and Safety Profile - Medscape - September 17, 2024.

Hormone Therapy Can Benefit Women Into Their 80s - Medscape - September 12, 2024