The Long And Misunderstood History Of Hormone Replacement Therapy

by Dr. Charles Mok, Contributor. Forbes.com

It is time for all women to understand their options when it comes to seizing control of their quality of life.
In the 1980s and 1990s the number one prescription medication in the United States was the estrogen-based menopausal treatment, Premarin. For decades, women with symptoms of menopause found improved quality of life with hormone replacement.

In 2002, everything changed. A specific drug called Prempro—a combination of a synthetic estrogen and a synthetic progestin—was found to cause an increased risk of breast cancer in women taking it over long periods of time. The result of these findings was widespread reduction of the use of hormone replacement, and the common—but misinformed—belief that hormone replacement therapy was “unsafe.”

The problem? At the time, there were substantial flaws in the original interpretation of the study’s results. Most importantly, discussions over the results made no distinction between the synthetic and natural forms of hormone treatment.

Around this same time, another hormone was being assessed for use in menopausal women with sexual disorders: testosterone. While perhaps surprising, it is important to understand that testosterone is the dominant hormone in women. In fact, women have about 20 times more testosterone than estrogen. All estrogen in women is synthesized from testosterone or a testosterone-like hormone. Without testosterone, there is no estrogen. In the early 2000s, the medical community knew that testosterone could be used to improve sexual disorders in women; but we were quite unclear on how dominant of a hormone testosterone was.

So in 2004, researchers in Australia studied the effects of adding testosterone “pellets” to conventional hormone replacement therapy. A testosterone pellet is testosterone compressed into a tiny grain of rice-like pellet that is inserted painlessly underneath the skin.

In this study, researchers noted remarkably reduced incidences of breast cancer in women taking testosterone in addition to conventional hormone replacement therapy, when compared to women taking conventional hormone therapy alone or taking no hormone replacement therapy at all. The study revealed that testosterone can suppress breast cell proliferation and the presence of breast cancer. Additionally, testosterone was found to improve the common symptoms of menopause.[1]

A 10-year study done in the United States reported similar results in 2013. Preliminary findings showed that using testosterone alone, without any other hormone placement therapy, not only improved all symptoms of menopause in women, but also resulted in a substantial reduction in expected breast cancer rates.