Tuesday, December 12, 2006

Dr. A Sets the Record Straight on HRT

I recently contacted Dr. A and asked if he would allow me to do an interview with him via email in regards to bio-identical hormones. Following her release of Ageless Suzanne Somers came under attack by her critics for printing false information on the success of bio-identical hormones. I wanted to know if HRT (hormone replacement therapy) in itself has been successful, and if there was any truth to the claims of the success of bio-identical hormones. Dr. A agreed to the interview under the condition that I gave the following disclaimer:

"I'm not a reseacher and in no way a specialist in menopause. I'm a primary care physician and the answers to the questions are from my experiences that I have with my patients and from some reading I do in the medical literature." Dr. A

Mary: How effective is HRT (in general) in post-menopausal women?
Dr.A: If you define effective as relieving the physicial symptoms of menopause, then in my patients, it is effective.

Mary: According to current research, are there advantages to taking bio-identical hormones over synthetic hormones?
Dr.A: In looking at some of the medical literature (which is not as extensive as others have done), I believe this is still an open question. As of this point, I do not think there is enough medical research to say if there is any advantage of bio-identical over synthetic. But, stay tuned.

Mary: Is there a safety issue in regards to taking either synthetic or bio-identical hormones?
Dr.A: The safety issues concerning synthetic hormones have been stated in the Women's Health Initiative. I have not seen research concerning any safety issues on bio-identicals yet.

Mary: One author has stated the following in regards to bio-identical hormones:
"This new approach to health gives you back your lean body, shining hair, and thick skin, providing you are eattubg and excersing in moderation. This new medicine allows your barin to work perfectly and offers the greatest defense against cancer, herat attack, and Alzheimer's disease."

Can HRT, whether synthetic or bio-identical of nature, bring these kinds of results?
Dr.A: This is such a vague statement that it can apply to just about any nutritional supplement or prescription medication. For example, this statement could be applied to the drinking of adequate amounts of water - let alone talking about HRT.

Mary:Is it possible for one person to gain these benefits and another not?
Dr.A: Of course.

Mary: Because diet and excersise were mentioned as componenets to the therapy, how much would they contribute to the success of the above mentioned without taking any kind of HRT?
Dr.A: An argument could be made that proper diet and exercise alone would give you pretty good health benefits without any kind of nutritional supplement or prescription medication.

Mary: According to the author, HRT is an age reversing therapy. Is it as simple as keeping your hormones at a certain level to maintain youth?
Dr A: To me, it sounds like a sales tactic to get you to buy their product. I've heard the same said about genseng and ginko biloba. If any physician said this about synthetics, they would be sued, because there is no scientific evidence that synthetics reverse age.

Mary: This same author has stated that by taking bio-identical hormones, she still has a period though she is in her 60's. Is this good for the body, or does it go against nature? Can having a period that long in life lead to certain cancers?
Dr.A: It is true that once menopause has been established, any bleeding from the vaginal area needs to be medically evaluated.

Mary: In terms of male menopause being the lowering of testoterone, can it really be reversed by adding it back in or taking DHEA?
Dr.A: This was a hot topic in the medical literature a few years ago. What we're finding now is that testosterone supplementation in males is not living up to its hype of a few years ago. But, research is still ongoing in this area as well.

Mary: Isn't the term "hormonal imbalance" deceptive since your imbalance can be normal depending on where you are in your cycle or where you are in life?
Dr A: Absolutely this is correct. I believe the term "hormone imbalance" is falling out of favor because it's used in a lot of different settings and people sometimes get confused. Some use the term referring to HRT. Some use the term in the mental health setting. And, still others use it when referring to underactive thyroid conditions.

Thank you Dr. A for taking the time to do this interview. Dr. A is a busy physician IRL, manages a popular blog as well as organizes Grand Rounds. Be sure to check out his blog and let him know you appreciate the information!!!