A Common Story We Hear at TREVI
It’s not unusual for me to hear from new patients: “Before I moved to Illinois, my ob-gyn prescribed hormones for me and I felt great, but my ob-gyn here told me that I’m risking cancer and a stroke. Now I’m afraid.”
Why would there be a difference in prescribing habits by state? After all, we’re all governed by the same societies—Ob-Gyn, Menopause, Urology, Endocrinology, to name a few. Each society looks at the research, makes decisions based on how they interpret the studies, and determines guidelines. The real issue is that we lack enough robust and solid research on hormone replacement therapy to entice all physicians to spend time studying the true benefits of hormone optimization therapies.
What Does the Research Tell Us?
We do have some data from the Women’s Health Initiative (WHI), but the women they studied were given conjugated estrogens, such as Prempro or Premarin (medroxyprogesterone). These were estrogen- and progesterone-like chemicals, rather than bio-identical estradiol and progesterone. And none of the study participants were on testosterone, so this data is incomplete at best. As for men, there isn’t even a small clinical trial following men who were given testosterone, let alone a large one.
Key Findings from the WHI
- Women on hormones who were diagnosed with breast cancer had better outcomes than those who were not on hormones
- Women on hormones had a lower incidence of colon cancer and osteoporosis
- Women on estrogen alone had a lower incidence of breast cancer
- Women on progesterone alone had a higher incidence of breast cancer
- Based on the ELITE study (2013), if we give women hormone replacement therapy within six years of menopause, we protect their hearts from heart disease—the leading cause of death in women
- Testosterone was used in the past to treat breast cancer in women, and some observational studies suggest that women treated with testosterone in the subcutaneous pellet form may have a lower incidence of breast cancer
Why the Divide Between States?
The evidence is mainly good, so why is there a divide?
My personal theory is that states with more sunshine hours and warm days simply have more residents who want to remain active as they get older. As a group, they’re not willing to accept platitudes like “what do you expect, you’re getting old, it happens” or “welcome to menopause.” Not to mention their doctors, who equally want to live more vibrant and active lives as they get older—doctors who do more reading on the subject, undertake more related training, and seek more such treatment for themselves.
More objectively, the variation between states could be influenced by factors such as regional medical practices, prevailing attitudes towards certain treatments, and the availability of specialized training and resources.
Finding the Right Provider
Illinois, like every other state, will have some doctors who are knowledgeable and supportive of hormone therapy. Regardless of what state you live in, it’s important to do the research necessary to find healthcare providers who have expertise related to those specific needs.
While I don’t believe that everyone should be on hormone replacement therapy, those seeking longevity and a better quality of life may benefit. We can never guarantee to prevent disease, but we always strive to improve our patients’ health, well-being, and enjoyment of life for as long as possible.
Don’t Accept “It’s Normal” as an Answer
If you are struggling with symptoms like brain fog, loss of energy, decreased sex drive, sleep issues, or unwanted weight gain, and you’ve been told “it’s normal, what do you expect, you’re getting older”—that is NOT a solution.
At TREVI Health—Longevity & Aesthetics, we work alongside our patients to set goals, create treatment plans that meet you where you are, and provide thorough assessments and support in a functional approach. We do not accept the status quo and we believe everyone is entitled to look and feel their best.
Schedule an individualized consultation and learn more at trevihealth.co or call/text (847) 802-9667 today.
