The Silent Health Crisis: Why Avoiding HRT May Be Riskier Than You Think

The Silent Health Crisis: Why Avoiding HRT May Be Riskier Than You Think

For decades, women have been told to fear hormone replacement therapy (HRT). But what if avoiding HRT is actually the riskier choice? New research suggests that saying “no” to hormone therapy isn’t a neutral decision – it’s an active choice that could have serious health consequences.

The Decision That’s Not Really a “Non-Decision”

When it comes to managing menopause, many women believe that taking no action is the safest path. However, Dr. Stephanie Faubion, director of Mayo Clinic’s Center for Women’s Health, emphasizes that “choosing not to treat menopausal symptoms is actually making a choice – one that carries its own set of risks.”

The Hidden Toll of Hormone Decline

The impact of declining hormones extends far beyond hot flashes and night sweats. Research has revealed a concerning array of health risks associated with untreated hormone deficiency:

Cognitive Decline:

Studies show that women who don’t use HRT have a 29% higher risk of developing dementia1

Bone Health Crisis:

Untreated women a higher risk of osteoporotic fractures2

Cardiovascular Concerns:

Women receiving HRT early after menopause had a 52% reduction in cardiovascular events3

Quality of Life Impact:

45-75% of menopausal women report symptoms such as chronic sleep disruption, mood changes, and intimacy issues that can devastate relationships and career performance as well as increase use of the healthcare system 4,5

Debunking the Cancer Concern

The infamous Women’s Health Initiative study that sparked widespread HRT fears has been largely reexamined. The North American Menopause Society (NAMS) now confirms that for most women, the benefits of HRT outweigh the risks when started within 10 years of menopause.6
Modern bioidentical progesterone has shown an improved safety profile compared to synthetic progestins. Micronized progesterone has lower cardiovascular, clots and embolism, and breast cancer risks compared with synthetic progestogens7

The Bottom Line

Every woman deserves to make an informed choice about HRT based on current scientific evidence rather than outdated fears. The risks of untreated hormone deficiency – including increased rates of osteoporosis, cardiovascular disease, and cognitive decline – deserve serious consideration.

References:

1. Nerattini M, Jett S, Andy C, et al. Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer’s disease and dementia. Front Aging Neurosci. 2023;15. doi:10.3389/fnagi.2023.1260427
2. Lorentzon M, Johansson H, Harvey NC, et al. Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials. Osteoporos Int. 2022;33(11):2297. doi:10.1007/s00198-022-06483-y
3. Schierbeck LL, Rejnmark L, Tofteng CL, et al. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. BMJ. 2012;345:e6409. doi:10.1136/bmj.e6409
4. Whiteley J, Wagner JS, Bushmakin A, Kopenhafer L, Dibonaventura M, Racketa J. Impact of the severity of vasomotor symptoms on health status, resource use, and productivity. Menopause N Y N. 2013;20(5):518-524. doi:10.1097/GME.0b013e31827d38a5
5. Whiteley J, DiBonaventura M daCosta, Wagner JS, Alvir J, Shah S. The impact of menopausal symptoms on quality of life, productivity, and economic outcomes. J Womens Health 2002. 2013;22(11):983-990. doi:10.1089/jwh.2012.3719
6. “The 2022 Hormone Therapy Position  Statement of The North American Menopause Society” Advisory  Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause N Y N. 2022;29(7):767-794. doi:10.1097/GME.0000000000002028
7. Stevenson JC, Rozenberg S, Maffei S, Egarter C, Stute P, Römer T. Progestogens as a component of menopausal hormone therapy: the right molecule makes the difference. Drugs Context. 2020;9:2020. doi:10.7573/dic.2020-10-1

Disclaimer: This article is for informational purposes only and should not replace professional medical advice. Discuss your personal health situation and risk factors with your healthcare provider.