July 13, 2002 was a time of confusion and misunderstanding concerning the article published in JAMA, July 13, 2002, concerning the use of synthetic estrogen and progestin.  The Women’s Health Initiative Study revealed that the combination of synthetic hormones, Premarin and Provera or PremPro, resulted in an increase risk of breast cancer and heart disease.  As a resident during this time, I saw many women go through withdrawal menopause and a drop in their quality of life.

Experts from all fields of medicine have called for a discontinuation of all hormone replacement as there have been ample evidence to implicate an increased risk of breast cancer and heart disease with the use of synthetic hormones.  Many physicians claim that hormones make no difference.  This defies the experience of many women who are on bioidentical hormones (identical to one’s own hormones).  Bioidentical estradiol and progesterone are potentially protective and when weighing benefits and risks, should be a part of the armamentarium to combat osteoporosis, female organ prolapse, loss of libido, vaginal dryness, frequency of UTI’s, cognition and mood.

Hormones are growth factors, so have the possibility of ‘fueling the flames’ of hormone receptor positive cancers, i.e. breast cancer that is ER+, PR+.   Cancer is a multifactorial disease and often have environmental (toxin based exposures), microbial, behavioral and emotional factors playing a role in its process. Hormones could potentiate a carcinogenic process.   Exogenous (taking hormones) and endogenous hormones (imbalance) can have a causal relationship to the development of female cancers, especially with longer duration of use or effect.  Benefits have to outweigh risks in making a decision to use bioidentical hormones.