The Tragedy of Women’s Hormone Replacement: A Q&A with Dr. Gustav Lo, MD

May 24, 2022

Q: Why aren’t more women treated with hormone replacement for menopause?

A: I’ll tell you exactly why, and it’s a story that’s impacted countless women. Back in the 80s, I was in med school when treating menopause with hormone replacement therapy (HRT) was becoming the standard of care. More than half of my classmates were women, and there was a strong emphasis on women’s health. Not addressing menopause symptoms was almost viewed as neglectful. Even then, we knew that hormone therapy went beyond alleviating hot flashes. It improved skin health, preserved sexual function, helped maintain cognitive abilities, and early research even pointed to longer life expectancy by reducing heart attack and stroke risks.

Today, we see firsthand how women want options that align with optimal health and wellness. Whether you were a family doctor like myself, an internist, or a gynecologist, treating menopause was part of our training, as 100% of women experience it eventually. For the first decade of my practice, when women began to show menopausal symptoms, I recommended hormone therapy, typically Premarin combined with synthetic progesterone. This helped millions of women. However, there was an issue.

Premarin wasn’t like natural human estrogen. It was derived from horses, hence its name: Pre-mar-in, short for pregnant mare urine. It worked for many, but it wasn’t ideal.

Then, in 2002, the Women’s Health Initiative study changed everything. It showed that using Premarin increased the risk of breast cancer and cardiovascular issues. This study completely transformed HRT recommendations. Doctors like myself, who had been advocating HRT, were suddenly faced with warning our patients about potential cancer and heart disease risks.

Fortunately, bioidentical hormones, which resemble natural human hormones, were beginning to emerge around the same time. These human-identical options reduced the risks linked to Premarin and synthetic progestins. However, the study’s findings left an enduring mark, and medical schools and residency programs stopped teaching about the benefits of HRT. Instead, they focused on the risks tied to animal-derived estrogen, even though these newer, safer bioidentical hormones were available.

This happened nearly 20 years ago, but many doctors still carry that legacy of fear. Conventional training emphasizes avoiding HRT due to outdated risk concerns, or it suggests that HRT only helps with hot flashes, overlooking the myriad of health benefits it provides.

Today at RegenCen, we offer options that weren’t available decades ago. We’re here to help you optimize your hormone health during perimenopause and beyond. If you’re looking for support to live your healthiest, most vibrant life, our hormone replacement therapy is here to support you with compassionate, expert care close to home.

Q: If bioidentical hormones are now known to be SAFE, plus prevent all these dangerous diseases AND make menopausal women feel so much better, why isn’t EVERYONE getting them?

A: I don’t actually know. Some think it’s all about money. You see, our own natural hormones are not patentable. Drug companies won’t spend hundreds of millions of dollars researching and promoting a product they can’t “own” the rights to. There would be nothing to stop company #2 from selling the exact same thing, without any of the expenses company #1 had. So no big-dollar pharmaceutical research has been done, and no big-dollar advertising or promotion to the public either. That means that few doctors will know about it, and few patients will ask about it.

The research was left to small groups, universities, and other grant-funded organizations. The studies are small and less well-publicized, so it’s taken a really long time (a solid 15 years) before there was enough data to show that bioidentical hormones not only avoid the risks of the previous generation of synthetic, brand-name hormones, but also increase the health benefits. Medical providers have therefore been very slow to change. To this day, most doctors remain unaware how clear the evidence of HRT health benefits has become.

How many more studies will need to be done before all doctors know bioidentical hormones cut the risk of Alzheimer’s in women by 50%? Or can make osteoporosis almost completely a thing of the past? How about make 90 the new 70? I don’t know how long it’s going to take, but I’ve never been good at waiting for the rest of medicine to catch up, and I’m not starting now.

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Posted in General, Bladder Control, Women's Sexual Health, Advanced Feminine Rejuvenation, Bioidentical Hormone Replacement