What the Media Got Wrong and What You Need to Know

If you Google “hormone replacement therapy” or “HRT,” you are bound to find articles warning you about its dangers. And you may be wondering if this type of therapy will cause more harm than good. Let’s set the record straight and separate fact from fiction by reviewing the study together that caused a media frenzy and stoked fears about the safety of hormone replacement therapy.

The Study That Caused the HRT Scare

The 2002 Women’s Health Initiative (WHI) study on HRT was and is one of the largest women’s health research projects ever launched in the United States. The WHI clinical trial and observational study enrolled more than 161,000 postmenopausal women between the ages of 50 and 79. The controversial study found there was a 26% increase in the risk of developing breast cancer in those who took hormones.

But that wasn’t the whole story for both how the study was conducted and its assumptions. Belmar Pharmacy’ Medical Director, Dr. Angela DeRosa, DO, MBA, CPE, mentions the false conclusions made by the media in her book, “A Woman’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You.” Dr. DeRosa noted the following:

• The study was based on two synthetic drugs — Premarin and Prempro.

• The 26% increase in the risk of developing breast cancer was based on the study’s findings that for every 10,000 women on hormones, eight women would develop breast cancer.

• Later analysis of the study showed no significant increase in breast cancer risk for women in the Prempro study and a 23% decrease in the Premarin group.

DeRosa described the study as badly designed and highly flawed because the treatment group consisted of older women who didn’t represent the population that usually uses HRT.

What is going on here?

“Hormones do not cause cancer,” Dr. DeRosa said. “It is actually common sense to use them to help treat symptoms associated with perimenopause and menopause like hot flashes, vaginal dryness, night sweats, insomnia, and mood swings.”
Dr. Angela DeRosa

More Critiques of the HRT Study

After the report was published and some of the media shared their misleading and out of context conclusions, it didn’t take long for experts to weigh in to critique the WHI study and which countered the media’s soundbites:

• James H. Clark, the author of “A critique of Women’s Health Initiative Studies (2002-2006),” one of the papers critiquing the study, concluded that treating postmenopausal women with Prempro did not increase the risk of invasive breast cancer.

• An article by R.D. Langer noted that the data didn’t support the fears of breast cancer.

Despite these positive findings by experts, there has been a 46% decline in HRT use since the study’s release due to the media making claims that were untrue about hormone replacement therapy. This trend is disturbing considering the number of women suffering from the symptoms of menopause who have decided, based on faulty information, not to access the benefits of HRT.

“Doctors have been trained to think hormones are dangerous for women,” Dr. DeRosa said. “But this is not true. Hormone therapy can be safe and effective when prescribed properly.”

What We Know For Sure About HRT

While the WHI study has received a lot of attention in the media, other studies and clinical practice guidelines support the effectiveness of HRT for treating menopausal symptoms caused by a hormonal imbalance.

“Hormones do not cause cancer,” Dr. DeRosa said. “It is actually common sense to use them to help treat symptoms associated with perimenopause and menopause like hot flashes, vaginal dryness, night sweats, insomnia, and mood swings.”

In his critique, Clark noted that most reproductive scientists believe that HRT should begin during the menopausal transition as a preventive therapy and not as a corrective one.

A Word of Caution When Researching HRT

It’s important that you are cautious when doing research, especially when it comes to articles about hormone replacement which can often be misleading. What we know for sure about HRT is that it can be safe when prescribed properly.  If you’re thinking about using this type of therapy, work with your doctor to make sure you understand the risks and benefits associated with it before making any decision.

Angela DeRosa, DO, MBA, CPE is the founder of the Hormonal Health Institute and serves as a paid consultant to Belmar Pharmacy. However, Dr. DeRosa is not an employee of Belmar Pharmacy and nothing herein should be construed as the promotion of Belmar’s compounded products over other hormone replacement therapies. Patients interested in hormone therapy are encouraged to speak to a medical professional about their medical options and before seeking treatment. Nothing herein should be construed as making a claim about the safety or effectiveness of compounded products, which includes compounded hormone pellet therapy. All information provided herein is based on Dr. DeRosa’s own clinical experience in her capacity as a board-certified internist.