Myth 1: Hormone replacement Causes Breast Cancer
The Women’s Health Initiative of 2002 showed the following results in three arms representing
10,000 women in each:
 38 vs. 30 cases of invasive breast cancer in the group using prempro vs no HRT
 Third arm not reported in the initial study was estrogen only (premarin) which was less than
30
 Prior to that study several smaller studies suggested estrogen may be protective against breast cancer-less invasive and better prognosis if it occurred
A follow up study 8 years later found the same trend of lower breast cancer cases in estrogen only group than in no hormone group.
In 2011, a study was done estimating the increase of mortality in women who would have been given estrogen only after a hysterectomy, and were not, or were taken off the estrogen that they were on.
The results were:
 The increased mortality was mostly due to cardiovascular disease
In 2013, Phillip Sarrel published a statistical estimate of the increased mortality from the publication of the Women’s Health Initiative to the present, of 20,000 to 90,000 women who have died prematurely.
The point is that these women may not have died if they were given hormone replacement, specifically estrogen.
Myth 2: Hormone replacement therapy is only for the purpose of stopping hot flashes
This conclusion was made by the FDA after reviewing the Women’s Health Initiative. There are few treatments that can even come close to adequately treating hot flashes; particularly without bad side effects. But estrogen therapy can do much more than simply take away a hot flash. The sad part is that a higher dose may be required to decrease anxiety, help with sleep, increase sexual desire, maintain brain functions, such as memory, protect bones, and protect the heart and blood vessels from acquiring plaque.
Myth 3: Hormones should be given at the lowest dose for the shortest period of time
This chant unfortunately came from the North American Menopause Society, as a recommendation of how to treat menopause based, again, on the Women’s Health Initiative’s misinterpreted statistics.
It is focused on the “dangers” of hormone replacement. There are many conditions that estrogen can treat which will resume with the individual’s discontinuation of their hormones. Examples would be

bone protection, brain and cardiovascular protection, and vulvovaginal atrophy. This is a condition of vaginal dryness and deterioration of cells, with resultant pain and sexual dysfunction. It requires treatment using hormone applications for life.
Myth 4: Bioidentical hormone are only present in compounded formulas
Not true! Several prescription items are available that are Bioidentical hormones. This means the molecular structure is identical to that which the person produced when the ovaries were functioning.
Bioidentical hormones may be compounded, but they are present in a variety of prescriptions as well.
They are different than non-Bioidentical hormones, such as premarin. One of the most important distinctions is that the strongest estrogen 17 B estradiol, has receptors in the brain specific to its structure. It is not present in premarin or cenestin, except possibly in tiny, if any, doses.
Myth 5: The superior delivery of hormones is in compounded creams, troches, or pills
Again, a huge misconception. Hormones love fat! If they are put in a cream, they are happy to stay there, instead of sinking in the body to the circulation. Creams with estrogen or progesterone should
NEVER be applied to the arms!! The hormones if they get in, will head directly to breast tissue. We don’t want increased breast stimulation! We want hormones in the circulation so they can go to the brain, bones, and heart. Progesterone is too large a molecule to be administered in a cream other than vaginal. It has been proven in repeated studies to be insufficient protection for woman who take estrogen therapy in menopause.
Any hormone that is swallowed or left under the tongue for any length of time, will be swallowed, let’s face it. When a hormone, such as estrogen is swallowed, it goes to the lymphatics, directly to the liver for detoxification and distribution to the rest of the body. Higher doses must be taken to make up for the amount the liver will detoxify and eliminate. The rest is thrown out to the circulation, which spikes up, is distributed to tissues, then goes down fairly rapidly. It is a rollercoaster effect.
Besides that, the bolus of hormones delivered to the liver, stimulate the liver’s other activities, such as making clotting factors This puts the patient at an increased risk of clots and strokes.
Treating women adequately with hormone replacement is important to prevent cardiovascular disease, brain and memory deterioration, and bone loss. It is also almost essential for adequate sexual function, preventing inflammation and osteoarthritis. It is not difficult to treat a patient adequately.
It is time that doctors step up to the plate, and take their responsibility to the patient out of exaggerated and erroneous statistics to a more reasonable and rational approach. It is time for all of us to open our eyes to the value of hormones to the human body. Let’s try squinting a bit at all the fear and panic that the press has generated, and save some lives in the meantime.