Is Hormone Therapy Safe for You?

By Arianna Sholes-Douglas, MD, FACOG

Who doesn’t want to look and feel younger? A flock of anti-aging products and medical clinics cater to this desire, but health experts caution that pursuing the so-called fountain of youth without being properly informed can be hazardous to your health.

Determining fact from fiction can be a challenge in today’s sea of contradictory Internet information, and hormone replacement therapy (HRT) is a good example. HRT, a popular choice of women to combat the effects of menopause, can pose health risks, while some medical organizations say it also can bring benefits.

The Internet is cluttered with myths and outdated information about hormone therapy, Nobody makes HRT easy for the patients — or most doctors — to understand. There is much debate in the medical community about who should be on HRT and who should not. But it is most important to see a provider who has your long-term health in mind.

Here are some important thoughts to consider when weighing hormone replacement therapy as an option:

• Remember: Not all hormones are created equal.

  Given the risks and potential side effects of traditional hormone therapy, women have considered bioidentical hormones as an alternative. These are manufactured from a plant chemical extracted from yams and soy, and they are identical in molecular structure to the hormones women make in their bodies. But bioidentical hormones carry the same risks as synthetic hormones. Bioidentical hormones are controversial, and the FDA has been slow to approve them. Yet whether you choose bioidentical hormones or traditional hormones, the three most common hormones that we try to balance through hormone replacement and supplementation are estrogen, progesterone, and testosterone. If you’re going to replace a hormone, it makes sense to replace it as closely as possible to the one that your body already produces

• Weigh carefully the risks versus the benefits.

  Don’t avoid replacing certain hormones because you think they might cause cancer. Even if a drug therapy has a theoretical risk, it’s not a risk for every person the same way. Genetics, diet, and toxic exposures all play integral roles. Estrogen in and of itself isn’t always the culprit. Do your research and discover the realities. Ask your gynecologist to evaluate the risks and benefits in your own case.

• Choose carefully where you get your hormones.

  FDA scrutiny of compounding pharmacies increased after such a facility distributed products that weren’t sterile, resulting in numerous deaths. Still, even with more FDA oversight, caution is advised. One of the trickiest aspects of prescribing hormones to patients is the role of compounding pharmacies. It’s important to do your research before enlisting one.

• Use sparingly.

  The goal of hormone replacement is to give you the lowest dose for the least amount of time. It’s probably going to benefit you most in your mid-40s to your mid-50s, an age range when hormones are generally considered safe, especially if you’re taking a low dose for a short period of time.

Most women can manage menopausal symptoms through diet, lifestyle, and supplements. But for some, HRT can be the difference between living your best life or suffering through “the change”. It’s not an easy road to navigate, which is why it is so important to be an informed patient.

Arianna Sholes-Douglas, MD, FACOG (www.drarianna.com), author of The Menopause Myth: What Your Mother, Doctor, And Friends Haven’t Told You About Life After 35, is the founder and visionary of Tula Wellness Center, a unique medical practice in Tucson, Ariz., focusing on women’s health and beauty. Dr. Sholes-Douglas has dedicated her career to helping women through the stages of life but currently focuses on treating women experiencing perimenopause and menopause. She is board certified in Obstetrics and Gynecology and Maternal-Fetal Medicine. Dr. Sholes-Douglas, who has practiced medicine for 29 years, specializes in integrative women’s health, a subspecialty of gynecology that incorporates evidenced-based alternative medical therapies to promote healing. She has served as clinical faculty at UCLA, the University of Maryland, and Johns Hopkins School of Medicine. Dr. Sholes-Douglas has made numerous media appearances on the Discovery Health Channel and served as the “Woman’s Doctor” on Baltimore’s NBC news affiliate. Her writing has been published in Good Housekeeping and Essence, and she’s also appeared in Yahoo! News and Prevention.