Estrogen and Progesterone: Prevailing Wisdom on Hormone Replacement Therapy

More than 20 years ago, Belgian physician Jacques Hertoghe lectured to American doctors about the benefits of estrogen and progesterone supplementation for menopausal women. At the time, millions of American women were already being treated with these hormones in order to reduce hot flashes and prevent a variety of illnesses. But a large- scale study in 2002 called the Women's Health Initiative (WHI) said that doctors had it wrong. The WHI reported that female hormone treatment actually appeared to cause a variety of illnesses, including cancer and heart disease.

 How did Hertoghe and thousands of American doctors get it so wrong? Actually, Hertoghe had it right because he recommended that only human hormones be given, at the right dose and in the right form. Two decades ago, most American doctors were prescribing a combination of synthetic progesterone and horse estrogen (literally, estrogen derived from horse urine), and they were giving it out in pill form. In fact, Hertoghe had specifically cautioned against using female hormones that were not “bio-identical” (natural to the human body). He also pointed out that estrogen should be given only through the skin, not as a pill.

 Subsequent studies have supported Dr. Hertoghe, repeatedly showing that real human hormones are much safer than their synthetic counterparts. For example, a 2005 study of 54,000 women in Europe (E3N-EPIC) showed that bio-identical estrogen applied to the skin, combined with bio-identical progesterone, actually reduced the rate of breast cancer. Women taking this combination of human hormones were actually 10% less likely to get breast cancer than women who took no hormones at all. But when the natural progesterone was replaced with synthetic progesterone, the rate of breast cancer went up by 50%. In 2008, another review in the British Medical Journal noted that estrogen given through the skin was much less likely to cause blood clots than supplements given in pill form. Following many similar studies, researchers recently stated that, “bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts” (Postgraduate Medicine 2009).

 While no medical treatment is 100% safe, real female hormones have been shown to improve health and restore quality of life. They can help control menopausal symptoms such as hot flashes, bone thinning, sexual dysfunction and poor sleep and may actually be good for the heart. On the other hand, synthetic hormones appear to pose unnecessary risk and should generally be avoided.

Michael E. Doyle, MD is a Board Certified medical doctor whose practice combines Conventional and Alternative Medicine and includes Nutrition and Bio-identical Hormones. Dr. Doyle practices in Stamford and can be reached at 203.324.4747. For more information visit GoToDrDoyle.com