Prescribing estrogen therapy for women has been a controversial subject for decades.
And if you are one of the many women making a decision about hormone therapy today,
it will help if you understand some of the history behind this practice. Ultimately
the decision to use hormone replacement therapy (HRT) is an individual one made
between a woman and her doctor. But it can be eye-opening to get some perspective
on how estrogen therapy came about, why it fell out of favor and how it came back
on the radar to again become the subject of intense debate.
The rise and fall of estrogen
In 1941, the Food and Drug Administration approved estrogen replacement for treating
symptoms of menopause. In the years following the first estrogen replacement prescriptions,
observational studies confirmed its benefits. By 1960, Dr. Robert A. Wilson’s bestselling
book, Feminine Forever, convinced women that menopause was caused by an
estrogen deficiency which could be completely avoided by estrogen supplementation.
This book promised that women would feel younger and happier and gave everyone hope
that estrogen replacement would prevent many of the diseases that become more common
as we age.
But in 1975, two studies reported that estrogen treatment increased the risk of
endometrial cancer, bringing estrogen therapy prescriptions to a halt. Yet within
the decade, new studies showed that adding progesterone to estrogen treatment eliminated
the cancer risks. By 1992, Premarin (estrogen made from the urine of pregnant horses)
was the most frequently prescribed drug in the US.
The Women’s Health Initiative
Estrogen (and progesterone) replacement prescriptions plummeted again in 2002 after
the Women’s Health Initiative (WHI) results showed that use of Prempro (the combination
of estrogen and synthetic progesterone) increased the risk of breast cancer, heart
disease, stroke, and blood clots. Women were abruptly taken off prescriptions without
being provided any other options for controlling their symptoms. Many women turned
to doctor-prescribed antidepressants or ended up suffering hot flashes, insomnia,
weight gain, and mood changes because they had nothing else to turn to.
More recently, scientists have re-analyzed the WHI data and determined that there
were major flaws in the study. For example, many women in the study were 10 and
15 years away from menopause. Others had hypertension and/or diabetes, already increasing
their risks for the other conditions.
Hormones as a form of false hope
What’s interesting is that so much of the positive hype around estrogen was based
on very little research. It shows us that hope is a powerful thing — especially
when it comes to promises of youth. Dr. Elizabeth Barrett-Connor writes in her review
of the book The Estrogen Elixir: A History of Hormone Replacement Therapy in America,
“Estrogen is about hope. Industry hype associating hormone-replacement therapy with
youth and beauty began early and continues today. In this regard, an unretouched
photograph of a stooped, wrinkled, old woman side by side with a ‘Botoxed’ celebrity
is worth a thousand words.”
At Women’s Health Network, we focus on health, rather than on the fantasy of finding
a fountain of youth. This is why we always promote a holistic view of the body,
taking into account how it works, and highlighting hormone-balancing foods and nutrition,
good sleeping habits, stress-reduction, regular exercise routines, and prioritizing
fun in your life. We also advocate for the safe use of herbs to resolve menopause
symptoms, if the prior steps aren’t making a big enough impact. And in the end —
for some women — hormones are truly the best answer.
What to do about HRT
As mentioned above, the decision to use hormones is entirely individual. The practice
remains controversial and is subject to a woman’s family and personal health history,
as well as her age and the type and severity of her symptoms. The jury is still
out on estrogen, and only time will tell if our current thinking is correct. Director
of the Yale Prevention Research Center, Dr. David Katz, writes in a Huffington Post
blog on estrogen therapy, “Evidence accumulates over time, and the weight of evidence
tips toward the truth. When science becomes a teeter-totter of sequentially opposed
truths, we have lost our way.”
Estrogen, and HRT in general, has come in and out of popularity and it seems as
if we, as a culture, have lost our way on finding what’s best for women. While scientists
hammer out the details of hormone replacement therapy, we advise starting with the
least invasive approach to relieving menopause symptoms. That means making a few
hormone-healthy food and lifestyle changes and supplementing with hormone-balancing
herbs. We’ve made it easy with our Hormonal
Health Program because we know that with a little support, your body knows
exactly how to achieve balance naturally.
For more information on HRT and lowering your risks, read our article
The real risks of HRT.
Wean off HRT safely, relieve symptoms &
avoid rebound effects with our exclusive Program.
Getting Off HRT Program takes the guesswork out of easing off hormone therapy
toward natural menopause relief.