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1. BHRT is safe

In spite of the press reports stressing bad news, virtually all of the major side effects from the WHI study have been withdrawn even by the investigators. It seems quite clear that the major side effects occurred in women who started using artificial hormones over the age of 60. The facts were that, properly used, there were fewer heart attacks, fewer deaths, fewer osteoporotic fractures and even less breast cancer. Synthetic hormones had one residual side effect - a very slight i.e. 1% extra lifetime risk of developing breast cancer but this is no more than the breast cancer risk of being overweight, drinking wine, having no children or even taking statins. Bio-Identical HRT is even safer as the risk of heart attacks is reduced even for women over the age of 60 and the 1% extra lifetime risk of developing breast cancer does not exist with Bio-Identical estrogen paired with Bio-Identical progesterone.

2. BHRT will stop your hot flushes and sweats

Uncomfortable hot flushes and severe night sweats causing chronic insomnia are characteristic symptoms of menopause. They may last for years and apart from being socially embarrassing they result in fatigue because of lack of sleep as well as depression. These symptoms can be cured with the correct dose of estrogen. No other treatment is nearly as effective.

3. BHRT increases bone density and prevents osteoporotic fractures

Every study confirms that estrogens are the safest and most effective way of increasing bone density. It is much more effective and beneficial than the bisphosphonates frequently prescibed. These non-hormonal drugs, with their considerable long term complications, should have no place in maintaining or increasing bone density in any woman eligible for estrogen therapy. For younger women receiving estrogen therapy for hot flushes, sweats or vaginal dryness they will have a significant increase in bone density over the years to such an extent that osteoporotic fractures 20 years later are much less likely to occur. For women who have low bone density, even without typical menopausal symptoms, estrogens must be seen as first choice therapy.

4. BHRT reduces the number of heart attacks

Over 30 years of evidence from many observational studies have demonstrated that estrogens reduce the incidence of coronary artery disease and heart attacks. This evidence was seemingly contradicted by the 2002 Women's Health Initiative (WHI) study which showed an increase in heart attacks. However, it has subsequently been proven that this study was flawed. It looked primarily at elderly patients who may already have had pre-existing heart disease, used the wrong dose of estrogen, the wrong drug (synthetic vs. Bio-Identical estrogen), delivered the wrong way (oral vs. transdermal), and gave it with the wrong progesterone (synthetic vs. Bio-Identical). Even with all these design flaws, subsequent analyses of the data showed a very much reduced incidence of heart attacks in women who started estrogen below the age of 60. The view now is that Bio-Identical estrogen, combined with Bio-Identical progesterone, has now been proven to reduce cardiovascular disease and heart attacks at ANY age.

5. BHRT reduces the risk of colon cancer

It is estimated that approximately 60,000 postmenopausal women will be diagnosed with colon cancer in the United States this year. The WHI study demonstrated a 37% decrease in colon cancer among postmenopausal women taking estrogen. This means that over 25,000 women per year would have been spared this devastating diagnosis is they had been taking estrogen.

6. BHRT reduces the risk of Alzheimer's disease

Alzheimer's disease affects one in 100 at age 60 and almost half the population is affected by age 85. Studies have shown that early treatment with estrogen and testosterone may prevent the onset of Alzheimers disease, but it has not been shown to be beneficial once Alzheimers disease has developed.

7. BHRT improves skin texture

After menopause, women lose about 25% of their body collagen which is manifested by thin inelastic skin, brittle nails, loss of hair and loss of the collagenous bone matrix. This latter loss is an essential cause of osteoporosis and osteoporotic fractures. Estrogen therapy replaces the lost collagen in skin, bone and nails. Its effect on facial skin is a very obvious useful cosmetic effect.

8. BHRT protects intervertebral discs

Estrogens prevent collagen being lost from intervertebral discs. These discs make up one quarter of the length of the spinal cord and act as cushions preventing compression fractures of the vertebral bones. It is these compression fractures that result in loss of height and a forward bending of the upper spine known as a Dowager's hump. This important protective effect of estrogens seems to be unique as bisphosphonates and the other non-hormonal treatments of low bone density do not have any affect upon the discs.

9. Estrogens will treat vaginal dryness, many causes of painful intercourse, and lack of libido

Thinning of the vaginal skin producing vaginal dryness is another characteristic sign of estrogen deficiency that occurs after menopause. This also can be successfully treated with estrogen either applied as a skin cream (transdermally) or as a vaginal suppository. Other related problems of painful intercourse and loss of libido are, depending upon the cause, also effectively treated by estrogens, testosterone and/or thyroid hormone.

10. Testosterone improves libido

BHRT certainly improves libido if estrogens are used to cure vaginal dryness and painful intercourse. However, if necessary, the addition of testosterone has an even more dramatic effect upon libido, frequency of intercourse and intensity of orgasm. Women must be aware that testosterone is not a male hormone. It is an essential female hormone that is present, in women, in 10 times the blood levels as is estrogen. It is an essential hormone, important for energy, mood, sexuality and bone density in women and is particularly needed in women who have had a hysterectomy with loss of ovaries and ovarian androgens

11. Estrogens help depression in many women

There is no doubt that depression is helped in postmenopausal women who have been suffering from night sweats, insomnia or vaginal dryness, painful intercourse and marital problems. However, the most impressive effect on mood is seen in younger perimenopausal women in the two or three years before periods cease. This is known as the menopausal transition period. Such depression often occurs in women who previously have had post natal depression and premenstrual depression. As premenstrual depression becomes worse with age it blends with the more severe depression of the transition phase but can be effectively treated by transdermal estrogen.

12. "I am a nicer person to live with"

Many women say that when estrogen therapy stops their depression, their loss of libido and their irritability, they become nicer people for their partners to live with. The depression, grumpiness and loss of energy can usually be improved considerably by the appropriate doses of the appropriate hormones. This may be testosterone as well as estrogen and progesterone.

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