Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women’s Well-Being and Lengthen Their Lives – Without Raising the Risk of Breast Cancer
Author: Avrum Bluming, MD, and Carol Tavris, PhD
Year Published: September 2018
Page Count: 242 – 6-7 hour read time
What It’s About:
“The current state of hormone replacement therapy (aka menopausal hormone therapy or MHT) is best described as confusing, rife with misinformation, and very polarizing. This book’s goal is to provide women with the facts and information they need to make informed decisions about their health. Estrogen Matters is a bold and compelling defense of hormone replacement therapy (HRT).
For decades, HRT was hailed as an undeniable benefit for menopausal symptoms, heart, brain, and bone. But in 2002, when the Women’s Health Initiative (WHI) announced results claiming that estrogen raises the risks of breast cancer and many other dire medical conditions, the winds shifted abruptly. Estrogen, officially deemed a carcinogen, was left for dead.
Twenty years later, Dr. Avrum Bluming, a medical oncologist, and Dr. Carol Tavris, a social psychologist, present a compelling case for its resurrection. They demonstrate not only that the WHI was seriously flawed, creating unwarranted alarms and fears, but also what years of scientific studies have actually found:
- HRT is the most effective treatment for menopausal symptoms, including hot flashes, night sweats, insomnia, vaginal dryness, heart palpitations, joint pain, and loss of sexual desire—symptoms that can last an average of seven years.”
The Take Aways:
After reading Estrogen Matters you will come away with the following thought provoking assertions:
- There is no evidence to support the current medical advice to take HRT at the lowest dose for the shortest period of time.
- Seven times as many women die of heart disease as die of breast cancer annually. In fact, heart disease, not cancer, is the leading cause of death among breast cancer survivors, and HRT can decrease that risk by 30 to 50 percent.
- The same number of women die annually following osteoporotic hip fracture as die of breast cancer, and HRT can cut this risk in half.
- Most studies have found that estrogen does not increase the risk of breast cancer, and it can often be given safely even to women who have had breast cancer.
The sensational headlines of the abruptly halted WHI study were that estrogen will give you breast cancer. And you’d be hard pressed to find someone of menopausal age who did not internalize that message. And that message is false.
Since Estrogen Matters was published, the authors have continued to gather evidence about estrogen’s benefits and reviewed studies. And they have followed the WHI’s own continuing reports. A 2021 update of the book includes the following:
“In 2020 the WHI investigators reported a 23% decreased incidence of breast cancer among women randomized to estrogen only (vs. estrogen and progesterone or placebo) — after 19 years of follow-up. It’s the combination of estrogen and progesterone, they still maintained, that raises the risk of breast cancer. But that finding has also been challenged. The women on estrogen and progesterone did not in fact have an increased risk. It was the control group that had a reduced risk. Because many of the women in that group had been on estrogen before the study! When they were removed from analysis, the supposed increased risk of breast cancer for those on estrogen and progesterone vanished.”
Our advice – As with any medication, have the risks and benefits explained to you by a qualified practitioner”. They can help you to understand if HRT is right for you.
Why you should read this book:
HRT is not a magic bullet, nor is it the evil presented by the WHI results in the early 2000s. The truth lies somewhere between these two polarities. Dr. Bluming and Dr. Travis do an incredible job of presenting little-known facts about the WHI and HRT. Facts that all women should consider when they are assessing how they will achieve optimal health in perimenopause and beyond.
This book pushes the HRT boundaries laid out by organizations like the North American Menopause Society (NAMS). The authors contend that estrogen is the one potential medication that can reduce the incidence of Alzheimer’s disease. The NAMS 2022 position statement says ‘hormone therapy is not recommended at any age to prevent or treat a decline in cognitive function or dementia’. Who is right? The better question: What is right for you?
When it comes to the menopause experience, most of us, including our medical providers, are woefully unprepared. To get the care and support we need and deserve, we need to be informed. And being informed means reading the information available and discussing the benefits and risks with a qualified medical provider in the context of our own unique symptoms and medical history. This book should be on everyone’s ‘being informed’ to do list.
If nothing else, this book will underscore for you just how little is known about the menopause transition and beyond. And we deserve better. Let’s start asking for better.