After  reading  the newest study of the dangers of hormones for menopausal symptoms, I think we need better information.

I contacted a colleague who is now in Colorado, originally at Harvard in Mass. Here is what he said:

“Many healthcare professionals have been asking for the opinions and/or responses of menopause experts to the recent JAMA(Journal of the American Medicine Association) article.

My comments follow as well as a link to the web site of Wulf Utian, MD, founder and long-time executive director of NAMS (North American Menopause Society) who recently stepped down from that post after 30 years.

1) This is still the same WHI (World Health Institute) Study with one drug, Prempro, in one dose only, given to women averaging 64 years of age when the study began. The wrong drug, in the wrong doses, to the wrong women.

2) This study has absolutely NO impact on you if you are not taking Prempro!

3) As the WHI has previously shown years ago, and repeated in this study, there is a very small increase in the risk of occurence of breast cancer when taking Prempro, which as of late did not reach any statistical significance at all. This increase was not seen in the Premarin (estrogen-only) part of the study. In fact, in the Premarin-only part of the study, regardless of their age, the women who were greater than 80% compliant with their use of the drug…meaning they took their dose when they were supposed to…had a statistically significant decreased risk of breast cancer!

4) This emphasizes once again that something about the progestin used in Prempro, called MPA, helped cause the small increase in breast cancer not seen in the Premarin-only arm. This has been shown in many other studies over the past 30 years:

estrogen alone = no increase in breast cancer risk

estrogen plus MPA = small increase in breast cancer risk

This is why most clinicians do not use this MPA any longer, and haven’t for some time.

5) The increase in the risk of death from breast cancer while taking Prempro compared to placebo, in this newest report, was one woman per 10,000 women per year…a level described as “extremely rare” by the FDA.

6) Every study is a piece of a puzzle. Sometimes that puzzle can have 50 to 100 pieces to complete and learn the real association or outcome. Unfortunately, the media treats each puzzle piece as a completed puzzle, hence the confusion and potential for panic. In discussing this study, there has been no attempt to put it into context so women can better understand the whole picture of risk vs benefit of taking this drug or any other Hormone Therapy (HT) for menopause. Benefits of HT, shown in WHI and many other studies prior to as well as since WHI, in the appropriate women using the appropriate doses of the appropriate HT begun at the appropriate time, include a decreased risk of heart attack (by far the biggest killer of women each year), diabetes, osteoporotic fracture, colon cancer, and the risk of dying from any cause at all (total mortality). These potential benefits are above and beyond the symptom relief of hot flashes, night sweats, sleeplessness, palpitations, headaches, mood disorders, joint pains, vaginal dryness and pain with intercourse commonly associated with menopause, that can be so disruptive.

7) Within this context of risk vs benefit, as with any medication or drug, a woman can properly discuss her own individual situation with her doctor or nurse practitioner and make educated decisions without the fear and panic that comes from such irresponsible and alarmist reports and media coverage.

8) There is a growing body of data demonstrating that the use of non-oral estrogen, via patch, gel, or vaginal ring, is safer to use than estrogen pills by mouth, taking away the risk of blood clots, and stroke from blood clots, seen with the pills used in WHI, as well as other benefits.

9) This is why we made the documentary movie, Hot Flash Havoc, to expose how these studies can be misrepresented, and to empower women with the knowledge to make better healthcare decisions.

In addition, please copy this link to Dr. Utian’s website    and click on the breast cancer study on the left side of the homepage for an excellent assessment.

More will appear shortly.”

Alan Altman MD

President, ISSWSH

Consultative Gynecologist for Menopause and Sexual Dysfunction

Aspen, CO


So after all that, I have reversed my own decision and I’m ready to take the plunge. By the way, I am taking a formula compounded especially for me. You can, if you’re interested, go to www. for her discussion of bio-identical hormones. It’s your body — make informed choices.

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