Hormone Replacement Therapy (HRT) Risk and Benefits with Dr. JoAnn Manson
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- Опубліковано 5 вер 2023
- Join Andrea and Dr. JoAnn Manson as they re-examine the results of the Women's Health Initiative Study.
0:21 Andrea outlines the many accomplishments of Dr. JoAnn Manson.
2:18 Andrea and Dr. Manson discuss how the WHI Study focused on post-menopausal women's health and the purpose of the three trials. Two trials focused on hormone therapy and preventing chronic diseases such as heart attacks, strokes, cognitive decline, and related outcomes not the effectiveness of hormone therapy. Another study focused on calcium and vitamin D and the relationship to reducing fractures. The third study was the low-fat diet and whether it correlated to lower breast and colorectal cancer incidences.
7:47 How the results of one of the studies became the focus and controversial.
13:45 Discussing how hormone therapy has evolved and changed since the study 20 years ago.
18:51 Information on how the medical education system short-changes women in perimenopause and menopause.
23:50 The importance of behavioral and lifestyle changes that can be made to improve long-term health outcomes that was studied in the Nurse's Health Study.
26:05 Hormone therapy and the nuances of the findings of therapy in early menopause vs. studying women in their 60s, 70s, and 80s.
30:14 The current thinking about the best candidates for hormone therapy.
34:05 If Dr. Manson could redo the WHI study what would she do differently?
39:46 Next steps women can take in finding a practitioner.
JoAnn E. Manson, MD, MPH, DrPH, MACP, is a Professor of Medicine and the Michael and Lee Bell Professor of Women’s Health at Harvard Medical School, Professor in the Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Chief of the Division of Preventive Medicine at Brigham and Women's Hospital (BWH). Dr. Manson is a physician epidemiologist, endocrinologist, and Principal Investigator (PI) or co-PI of several research studies, including the Women’s Health Initiative Clinical Center In Boston, the cardiovascular component of the Nurses’ Health Study, the VITamin D and OmegA-3 TriaL (VITAL) and the COSMOS trial.
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Wow, it was great listening to her perspective on HRT. If I'm not mistaken, she said that,
as for heart attack, stroke and dementia, the benefits of using HRT do not out weight the risks, and that is the opposite of what I've been hearing with the doctors on you tube. So now I'm a bit more confused.
I would like to know if the doctor uses HRT ?
I loved the interview, always enjoy your videos 🫶🫶🫶such an important topic & always learn something. Thank you so much for all the time you put in 2 educate us 🙏 💜
Thank you Melissa!! I love hearing that. You are very welcome. 💙
Good video. Thank you.
Thank you! I'm happy you enjoyed it.
Another great interview, thanks Andrea
Thank you so much Linda! 💙
That was extremely informative
Thank you so much! Appreciate your feedback. ~ Andrea
Glad to hear Dr. Manson urging caution about bioidenticals and the "non-Premarin" class of estrogens since no large scale trials have proven their superiority. Indeed, the KEEPS trial which she helped lead found that, compared to Premarin, transdermal estradiol actually WORSENED the effects of pericardial fat accumulation on coronary calcification, suggesting that this formulation might pose unique cardiac risks different from Premarin.
Also glad to see that she defended the WHI, which has been unfairly criticized as a flawed study. Well its critics would be singing a different tune if it had produced the results they wanted. But it was a very well done trial that was state-of-the-art at the time. Looked at the the most commonly used hormone therapies (Premarin/Prempro) and studied them across all ages and demographics, reflecting the prevailing practice and "wisdom" of the time -> they're good for all menopausal women without contraindications, regardless if they have symptoms or not.
Thanks for your comment Jonathan. I loved interviewing her. We will be doing it again in February 2024 so stay tuned!
I recommend the book “Estrogen Matters” to you, by oncologist Avrum Bluming MD and social psychologist Carol Tavris PhD, for everything you need to know about the WHI and HRT.
ua-cam.com/video/v9bTxPA51Ms/v-deo.htmlsi=OlJwTD51oh5CvGYl
This fascinating in-depth, entirely evidence based analysis of the WHI by professor James Simon MD, titled “Lies, Damn Lies and Statistics” might also be helpful for interested people.
Would she say to avoid HRT for prevention even if you have early-early menopause (30s POF)?
Consider transdermal estrogen and progesterone up to the average age of menopause. You can be gradually, over several months from your hormones at the average age of menopause. From my personal experience I can tell you that stopping hormones cold can cause severe withdrawal symptoms. Good luck, remembrr once your estrogen drops off you are at increased risk of heart attack AND you will inevitably you will lose bone mass and this could cause severe osteoporosis by the time you are around 60.
thank you so much @@lindajones4849
now wondering if just taking hormonal birth control with estrogen and progesterone will do the trick for now?
@ones4849 Hi Linda, check out what she said at the end of the video. She said Don't initiate (HRT)for the express purpose for preventing heart attack, stroke, dementia and some cancers, because the risk do not outweigh the benefits. So now I'm confused because I, like you, heard just the opposite from other you tube doctors.
I had a mammogram and was told I have dense breasts which increases my breast cancer risk can i still get on BRHT?
Hi. That would be a conversation to have with your doctor. :-)
Take iodine daily for that