Got Menopause and Afraid of Hormone Therapy?

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If you are like many perimenopausal women, you may be suffering from insomnia, emotional highs and lows, hot flashes, brain fog, dry vagina and other challenging, quality of life-changing symptoms.

So why are so many women suffering?  Most of them are afraid of hormone replacement therapy (HRT). Today it is often referred to as hormone therapy (HT) or menopausal hormone therapy (MHT).  I speak with so many women who feel like an alien has taken over their body. They are struggling at work and in their marriages, but they will not even discuss taking HRT with their healthcare providers. They are convinced that they will get breast cancer or drop dead of a heart attack.

Why are they so afraid of HRT?  Most of them heard the sound bites and information that was reported about the early termination of a WHI (Women’s Health Initiative) study in 2002 on hormone replacement therapy, which erroneously indicated that HRT caused heart attacks and breast cancer. This reporting led doctors to immediately stop prescribing HRT. Many women kicked their HRT to the curb. Duck — dangerous mood swings ahead……….!

Professor Robert D Langer, one of the principal investigators in the WHI, in a paper titled, “The evidence base for HRT: what can we believe?”, raises serious questions about the ‘facts’ that have led women and their doctors to believe hormone therapy is unsafe.

Professor Langer says that the distorted reporting of the WHI findings triggered a sensationalized cascade of fear and the flight from appropriate use of HRT. He reports that, in an unprecedented departure from accepted practice, the incendiary initial results paper was written by a small group of individuals and kept secret from the vast majority of scientists in whose names it was submitted until after it was accepted by the journal. The unfortunate result was that the paper misrepresented the findings, and made inflammatory claims that were not supported by the data when viewed according to the pre-established study protocol—which was largely abandoned in this and subsequent reports.

Professor Langer also points out the following:

The WHI was conducted to test if the benefits that had been seen in women starting HRT near menopause would be found in women starting this treatment a decade or so after going through menopause, and that the study purposely did not include enough recently menopausal women to assess outcomes in that age group.

The initial results were generalized from the older women to younger women, twisting the logic of the study in a scientifically inappropriate manner.

The second half of the trial was omitted from the published study and had data that was contrary to the original report. The omitted part of the study was reported two years later and showed that HRT reduced the risk of breast cancer and heart attacks in women under 60 years of age. (Were you aware of this report?!?! I bet not!) In recent years, hormone replacement therapy has improved with the help of subsequent clinical trials proving that HRT regimens could prevent heart disease and hip fractures.

The aftermath has been that women with significant menopausal symptoms such as hot flushes, night sweats, insomnia, joint pain, anxiety and lowered mood (approximately 1 in 3 women), have been mostly untreated for 15 years.  (This is a crime in my book!) Not only have women been denied symptom relief but they have also been denied the other benefits of HRT- including unarguable protection against bone loss and reduced risk of fracture!  In recent years, hormone replacement therapy has improved with the help of subsequent clinical trials proving that HRT regimens could prevent heart disease and hip fractures.

Is your blood boiling yet??  No, you are not having a hot flash…..that boiling heat you feel going through your body is anger! HOLY SH-T!

In this new study, the International Menopause Society (IMS) recommendations on HRT suggest that we need serious questions raised about the need for professionalism in the quality of protocol, data evaluation, and author approvals when submitting scientific reports. The new study also shows a need for a better understanding of hormone replacement therapy and its risks and benefits. It is now apparent that HRT is an effective preventative treatment if prescribed to healthy women who have been postmenopausal within 10 years, and the benefits outweigh the risks. (Please take a moment to re-read the previous sentence.) For most women, HRT can help alleviate many menopausal symptoms as they make this important transition in their lives.

So listen up ladies, quit suffering in silence and find a good menopause specialist who is up on the latest information and science! If you don’t have one, here are some helpful tips.  If a healthcare provider tells you that they flat out don’t believe in HRT.  Run, don’t walk, out of that office as clearly this healthcare professional isn’t up on the current information that many researchers who truly care about women have been trying to impart for many years now. Your healthcare provider may be just covering his ass and not protecting yours!

Also, download my Menopause Symptoms Chart.  Start charting your symptoms so that you can accurately and quickly explain to your specialist exactly how you are feeling.

There is no one-size-fits-all solution for the symptoms of menopause. For example, if you are a cancer survivor your options may be different than someone who has a history of heart disease in their family. Your menopause specialist should evaluate your symptoms, quality of life, and personal health info and create an individual program to fit your personal needs.

If you aren’t getting the help you need and deserve, find a new healthcare professional!  No divorce attorney needed.

You CAN lead a happy, healthy, productive life in perimenopause, menopause, and post-menopause.

My Motto:  Suffering in silence is OUT!  Reaching out is IN!

For more helpful information download my free eBook: MENOPAUSE MONDAYS The Girlfriends Guide to Surviving and Thriving during Perimenopause and Menopause.

Professor Langer’s paper will be published in the forthcoming April edition of the journal of the International Menopause Society, Climacteric.

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • Shannon Bowman

    I started a bioidentical hormone therapy last summer after avoiding the conversation for years…all the while suffering with severe menopause symptoms including mood swings, insomnia & nights sweats, hot flashes, weight gain, etc. I found a phenomenal doctor who is committed to my complete well being and now, I honestly feel like I did in my 30s. I am full of energy, able to sleep 8 hours and have NO mood swings, no night sweats, no hot flashes. Everyone needs to do what’s best for them but for me, this hormone therapy has been life changing!

    • Thanks for sharing your journey with us, Shannon! I am so happy that you found a “phenomenal doctor” to help you with this menopause business. It is so important!

  • Neena

    Thank you, Ellen, for highlighting this travesty. My a doctor — a woman — told me HRT is linked to cancer, forget about it. She was dismissive of my symptoms and even more dismissive when I asked she read the latest research. I’ve been suffering in silence and dilly dallying about finding a new provider. Thank you for giving me permission to dump her.

    • Neena, I am so glad this blog has ignited you to find a new menopause specialist who is truly educated about the latest information and studies. Be sure to download my Menopause Symptoms Chart from my homepage. Start charting your symptoms before you got to your new specialist. It will help them understand how you feel. Chapter 13 in my free Ebook will help you find a good specialist! Good Luck!

  • Randie Noell

    Thank you Ellen for sending today’s email. Sometimes I feel that the truth of this study–and the myths that were propagated about the study–should be shouted from the highest mountains. I consider myself extremely lucky that I had a wonderful doctor who encouraged my being placed on HRT the minute I started dealing the debilitating perimenopause symptoms I encountered 20 years ago. Not only did he encourage using HRT, he was also completely aware of the missing info contained in the study. Throughout the last 20 years I have met zillions of women who are suffering with perimenopause/menopausal issues. They are afraid to take HRT–mostly thanks to their doctors who have discouraged them from having anything to do with estrogen–all in the name that study. When I tell them I’ve been using HRT since I was 45 their jaws drop. Because of the extreme symptoms I dealt with during perimenpause, I am still not sure what would have happened to me–mentally and physically–if I had had a less knowledgable doctor. Thanks, again, for getting the word out about this crazy study!

    • Dawn P

      Randie, Have you had any bad effects from your HRT such as those listed in the info that accompanies the meds?

      I had a hysterectomy at age 38. Then at age 53 I went on an estrogen only patch (Vivelle DOT). I felt great on it. After 5 yrs. on it I had to have my gallbladder removed–gallbladder disease is a side effect of HRT therapy. Since then both parents, especially my mother, are suffering from dementia. Dementia is also a known side effect of HRT therapy and this scared me so much that in July 2016, after 9 yrs. of using an estrogen patch I went off of it. Since then and still today 8 months later I suffer from many hot flashes, have gained weight especially around my middle, and seem to have more aches and pains than before, however, I am now 63. I don’t know what to do–should I ride it out or go back on estrogen? My gynocologist says don’t suffer but I fear dementia very much. Can anyone shed light on this from their experiences?

      • Randie Noell

        Hi Dawn,
        I completely understand the fear of using the patch when you read the side effects that can happen. I ordinarily have side effects with every drug I have taken throughout my life, but (thankfully!) with the estrogen patch I have felt nothing but complete relief from insomnia, hot flashes, mind fog, as well as another dozen issues that cropped up during perimenopause–and I’ve been on the highest dosage that can be dispensed using the 0.1 Miniville patch. I had so many health issues attributed to perimenopause that I had no choice but to use the patch. I literally had to try using the patch or never leave the house! Interestingly enough, over the years I have tried several times to go off the patch by reducing the dosage and ended up with bouts of vertigo that disappeared once I went back on the patch. I know the dementia issue listed on the side effects is unsettling, but I have had to weigh this side effect with having a current quality of life. I know it’s an unsettling issue. That study did a lot of women a huge disservice by simply not providing all the information it should have provided. I have met lots of women who have and are suffering through their menopausal symptoms unnecessarily out of fear because of that study. Weighing all the pros and cons the best advise I can offer you is to do what you feel most comfortable with while taking into consideration what makes you feel best health-wise. Hope this helped!

        • Dawn P

          Thank you for your thoughts and advice. Now I have a decision to make. Thanks again and glad to know you are doing well on HRT.

          • There is no one-size-fits-all solution. Read my free eBook which you can download from the homepage of this site. Then find a good menopause specialist who is up on the latest information and studies. Together you can find the right program for you! Good Luck!

        • Dawn, thanks for sharing your journey with us. It is so helpful for others to know that they are NOT alone! Many women find this kind of relief from the patch. The truth is the patient insert on Advil might cause some people to pause. It sounds like your HRT program enabled you to get your life back!

      • Ladies, When our Estrogen levels start to plummet during menopause it can impact memory. Estrogen, also, helps regulate levels of another hormone, called cortisol, which affects how the chemicals in your brain work. My first symptom was severe brain fog. I could not keep a thought in my head. My HRT lifted that brain fog, memory loss!

    • Randie, thanks for sharing your personal journey with us. You were lucky indeed! Me, too! I was lucky that I was in the kitchen of a retired Gynecologist when I suddenly broke out in hysterics. He put his arm around me and asked what was going on. I told him that I had severe brain fog, couldn’t sleep, and my mood swings were so crazy that I felt like an alien had taken over my body. Thankfully, he told me that I was in perimenopause. Of course, at first, I was shocked! I was “young”……..I thought menopause was going to happen when I was “old”! After suffering needlessly………I found a great menopause specialist and well………..the rest is history. I self-published my first book about menopause and created Menopause Mondays. I had to tell other women the facts about perimenopause, menopause, and post-menopause and the options available. My self-published book was picked up by a publishing house and re-published, and now I have published a free eBook! I don’t want anyone to suffer like I did because they can’t afford to buy a book. My motto is: Suffering in silence is OUT! Reaching out is IN!

      • Randie

        Hi Ellen,
        Our perimenopause stories are so similar! It’s comforting to know that I was not alone regarding how I entered such a frightening time in my life. I remember thinking that I was going to have to learn to live the remainder of my life as a blubbering mess just sitting on the couch. To this day, I don’t know what would have happened to me had I not found the wonderful doctor who expertly guided me out of such a very difficult time. Thanks so much all the work you do to keep all of us so well informed!

        • Randie, it is wonderful that your menopause specialist created an individualized program to meet your personal needs. It is so important! Now it is up to us to spread the info to the next generation so that they don’t think they need to suffer needlessly. There ARE options and solutions to ensure that we lead a happy, healthy, productive life in menopause and beyond!

  • Excellent advise Ellen. Truly you are hiring a doctor for their expertise and part of that is listening to you and making suggestions of what is best for you, not all women, not some women, but you!

    • Totally, Haralee! Each women’s journey is different. It is vital to be able to discuss our healthcare decisions openly and honestly with our healthcare professional. It is, also, vital that the healthcare professional is up on the latest information and science!

  • Roxanne Jones

    Wow. This is the most cogent explanation of the WHI study–and the travesty of how information was (mis)communicated when the study was terminated early. Thank you for being such an articulate, passionate advocate, Ellen!

    • I am so happy that you felt the blog was easy to understand. That is my goal……….I do the research and then impart the info in layperson speak.

  • I am sharing in multiple ways. It’s important stuff. Showing us just how some docs are uninformed….sigh.

    • Thank you for sharing the information, Carol. Through our social media networks, we CAN help educate the sisterhood. I hope that through sharing good info, we can ensure that women are proactive instead of reactive about their health.

  • Estelle Sobel Erasmus

    The message you are sharing is so important so that women don’t feel fear when they reach menopause. My explaining the WH study you add to the understanding of the issue, which is so needed.

    • Thanks, Estelle. It is my mission to make sure that women are armed with the correct information so that together with their menopause specialist – they can make healthy decisions so they can continue to feel good during menopause and beyond!

  • Cathy Sikorski

    Two years ago I ran into a friend at the hairdresser who told me about her joys of bioidentical hormones. I made an appointment right away, as I hadn’t slept for 7 years. I met with a nurse practitioner, Becky, who I will tell you, I believe saved my life as I know it. My gynecologist does not ‘do’ HRT but does not dissuade me from doing it. I now have 2 gynecology practitioners. I love Becky, She gave me all the research, answered all my questions. Takes time when I”m in her office every 3 months for my pellets to discuss my healthy. And, actually has become a social friend! Many women try to ‘swear me off’ HRT. But I’m having none of it. I ‘m healthy, I sleep, my hair is gorgeous, I’m active and sexual and live is good. Sixty is the new forty!

    • Cathy, thanks for sharing your story with us! I am usually not a huge fan of the pellets because it is hard to tweak them if you find you have been given too much……..it was nice to hear your success story!

  • Linda

    Hi everyone, 5 years ago when I got my first hot flash followed by a list of everything that goes along with menopause and feeling like crap… Yes the menopause alien, grrrr!!! My dr started me on bio identical HRT. Starting with my thyroid, then working through other issues. I have auto immune disease so we had to work through this one step at a time, and it was the MOST challenging experience with my body I have ever experienced. At a time when you can’t think straight plus have 0 energy and patience. We need to be patient for our body’s to get balanced again. It doesn’t seem possible but they will. Fear of helping ourselves feel better is not going to give us what we need. If a person is a diabetic do they take what they need? Some may think this is too dramatic of a difference, but not if you’ve known women who have been suicidal or actually followed through. It’s that serious!

    • Linda, I can’t agree with you more! Suffering is silence is out of the question. When I was at the North American Menopause Conference this past October. Experts were telling the room full of menopause specialist to consider the women’s quality of life when developing her individualized program. It is a crucial part of the equation. I, also, found that I was suffering from menopausal symptoms coupled with a thyroid condition that I didn’t know I had! That was a perfect storm! OY! I have a chapter dedicated to thyroid issues in my free eBook, MENOPAUSE MONDAYS The Girlfriends Guide to Surviving and Thriving during Perimenopause and Menopause. The symptoms can be similar, so it is good for women to get a thyroid panel done when they go to their menopause specialist to make sure you are treating the correct issues.

  • This is all so enlightening. Thank you so much for sharing your knowledge with us. I was terrified of HRT because my mother, stepmother and both grandmothers developed breast cancer after 60 after using HRT. I was even terrified to try homeopathic remedies.

    • I totally understand how you must be afraid of HRT. It is important for your specialist to take into consideration your family history. Again, it is good to note that the options for HRT that we have today, are different than those our mothers took. If you are still having symptoms that you find impairing the quality of your life. Please download my free eBook and read the chapter related to those symptoms. I do list some non-hormonal tips for hot flashes & night sweats in the book!

  • OaktownGirl

    Hi. I am 53. I have horrible, body-drenching (sweat) hot flashes multiple times per hour. Last year I started an OTC progesterone cream which helped immensely, but it brought my period back so I “weaned” myself off it. I was semi-ok for a while (re: hot flashes), but now I’m back to where I was. Also, if I keep losing head hair at the rate I’m losing it now, I might not have any left in 4-6 months, or I’ll have to cut it extremely short and hope that helps keep it from falling out so much.

    If I start on HRT, do I have to be on it for the rest of my life? Also, can someone please tell me what “bioidentical” hormone is that I’ve heard mentioned in this thread? Thank you in advance. I am most grateful for any help.

    • Hi OaktownGirl………..get thee to a menopause specialist asap! In addition to a full conversation about your menopause symptoms, I would talk to your specialist about doing a thyroid panel on you as well. Hair loss can, also, be a sign of thyroid issues. Many women find that they are dealing with both issues at the same time. Some of the symptoms are similar. Please download my free eBook, MENOPAUSE MONDAYS The Girlfriends Guide to Surviving and Thriving during Perimenopause and Menopause. Read the chapters on finding a good menopause specialist in your area and the tests to ask for. In addition, read the chapter on hot flashes and night sweats, thyroid issues and hormone replacement. All HRT is not created equal. A bioidentical hormone is identical to the hormone produced in your body. It has the same chemical structure. Just because a hormone was derived from a natural product does not mean it is bioidentical. if your HRT was derived from a plant or animal hormone and then chemically altered to become identical to a hormone found in your body – it is bioidentical. A conjugated estrogen, ethinyl estradiol, esterified estrogen are not bioidentical. However, estradiol is bioidentical. Medroxyprogesterone acetate is not a bioidentical progestin. However, progesterone is. I hope this is helpful…..it is all spelled out in my free Ebook. Please go to the homepage of ellendolgen.com and download it. I know it will help give you the tools to get the help you need and deserve. You can always circle back with me anytime for more support. I answer all of my own emails……..even if I am hope in the wee hours of the night! I remember what it was like to feel like I was not OK. Good Luck!

      • OaktownGirl

        Thank you so much, Ellen, I really appreciate it!

  • Sarah Smythe

    Hi wllen

    • Sarah, I did not get your full comment. Please circle back and lmk how I can support you.

  • Sarah Smythe

    Hi there:

    I’ve been struggling with typical menopause symptoms and recently purchased an all-natural menopause supplement. Have you ever used something like this? It’s called Estrovive and can be found at http://www.Estrovive.com. I don’t really want to try hormone replacement therapy just yet, and would love to get your take on supplements like this. Thanks!

    • I am not a doctor or a scientist, so I am unable to prescribe any protocol. I do know that there are oodles of supplements out there as so many of these companies have reached out to me to endorse or write about their product. I have chosen not to do so, as women trust that they are going to get information that they can trust on my website and in my blogs. I have no way of vetting these supplements. However, I do interview experts in the menopausal world who often have vetted or speak about supplements. The oncologists at Yale Cancer Center who I interviewed for a blog on Menopause and Cancer. They did a study on Remifemin which is black cohosh. Since they treat cancer patients who often are immediately thrown into menopause due to estrogen stripping medication, they were interested in finding a supplement to recommend to their patients. They felt this black cohosh product was the purest. Here is a link to the interview: http://ellendolgen.com/2015/01/breast-cancer-and-menopause/

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