Many women (and their doctors) are afraid of hormone replacement therapy. The Women’s Health Initiative (WHI) study followed over 160,000 postmenopausal women taking premarin (horse estrogen) and medroxyprogesterone (synthetic progestin) for fifteen years, and this combination resulted in a slight increase in the rates of heart disease and breast cancer. Premarin alone showed a decrease in heart disease and breast cancer, and the combination showed decreased rates of osteoporosis, cancer and death. Premarin and medroxyprogesterone are not bioidentical hormones because horse estrogens are different than human estrogens, and medroxyprogesterone is synthetic. Synthetic progestins increase the breast cancer risk while bioidentical micronized progesterone decreases the risk of breast cancer. Progesterone also decreases the risks of uterine cancer, osteoporosis, and heart disease. Progesterone can additionally improve mood and sleep.

Oral estrogen and testosterone increase the risks of blood clots, heart attacks and strokes, but when estrogen is delivered by pellet or patch, it actually decreases these risks. Estrogen lowers cholesterol and blood sugars and lowers the risk of diabetes, fatty liver disease, colon cancer, and cardiovascular disease. Estrogen increases blood flow to the brain, decreases inflammation, improves mental functioning and mood, and decreases the risk of Alzheimer’s dementia. Estrogen builds bones and can prevent and treat osteoporosis.  Estrogen restores young, healthy vaginal tissue for optimal sexual functioning and prevention of urinary incontinence and urinary tract infections. Estrogen replacement can reduce wrinkles, joint pain, headaches, hot flashes, and night sweats. As long as you are taking the right hormones the right way, you can improve your health with very little risk.