HRT Report – A Doctor’s View

A recent study concluded that HRT at menopause does not lead to early death, but what do bioidentical doctors think?


I have been fortunate enough to work with a number of bioidentical doctors, including the late John Lee MD who was the pioneer of cream bioidentical hormone use.

After the recent press report on HRT risks in The Times newspaper I discussed this with Dr Tony Coope. He has been using bioidentical hormones with patients for many years and he made the following comments on it that he is happy for me to share with you.

Overall, this study is helpful in that it may at last take some of the ‘heat’ out of the contradictory and confusing arguments that have become the norm around this subject, and have contributed to many patients not receiving the help they need in conditions such as persistent/severe hot flashes or vaginal atrophy and inflammation.

Pre-existing conditions can make all the difference

But if we look at it more closely, we will see that while there is no increase in overall mortality across a large number of women, individual women with already existing pre-disposing risk factors (e.g. past history of DVT, pulmonary embolism or abnormal clotting factors on blood analysis, and very early but undiagnosed signs of beast cancer), are very likely to be harmed; women with conditions such as pre-diabetes and osteopenia/osteoporosis, however are much more likely to benefit.

So, while the overall death rate is unchanging, the individuals within a large group will be differently affected, some for the good, others negatively.

What are the risk factors?

For an individual woman, the key question must be ‘What is my situation as regards risk factors and conditions, when my increased risk in exposure to HRT to a particular outcome could be as high as 100%, or as low as 0%?’

Not very much seems to be written about this, but helpful actions in assessing it include study of past and family history, current and past lifestyle factors that may influence gene expression (epigenetics), and mental, emotional and spiritual problems (metaphysics).

A potentially helpful investigation would be the Urinary Metabolism of Estrogens test which reveals whether the breakdown of excess oestrogen’s in the liver is following a benign, or a more toxic path.

The role of synthetic progestins

Finally, it seems clear that it is the synthetic progestins in HRT that make the difference in the increased breast cancer risk.

Substituting the synthetic progestins with bioidentical progesterone is a relatively simple answer even though it is ignored by much of the mainstream.