Every week brings new conflicting headlines for and against sex hormone replacement for men and women. It is appropriate that this mission statement on HRT be repeated:
The “sex” in sex hormones may be a major distraction, since the major long term health issue about universal sex hormone decline with aging is not primarily about sexuality and hot flashes, but about ensuring a vibrant useful active independent second half of life (including sexuality) so that we die well – i.e. preventing the common major disabling aging diseases that rob us of decades of health.
It is about preventing the associated major risks of sudden death, or crippling diseases – obesity, diabetes, frailty, fractures, arthritis, heart attack, heart failure, stroke, visual and hearing loss, Parkinson’s, incontinence and dementia – and sexual impairment is sometimes the last complaint.
After insulin in 1922-3, human non-oral sex hormone replacement HRT was firmly established by 50 years ago by e.g. Schering AG and experts in USA, Canada, UK and Europe. Then Robert Wilson (Feminine Forever) and Industry introduced oral patent xeno – hormones (other non-human hormones -e.g. premarin and oral contraceptives- hormone therapy HT) “for women’s convenience” – and more profits.
Despite increasing warnings about cancer and thromboses with nonhuman especially oral hormones from the 1970s onwards, and sixty years of risk-free use of appropriate HT and especially balanced systemic Human sex hormones HuSH, the USA and Europe medical establishments then embarked determinedly in the 1990s with largely patent oral hormone therapy in the HERS, ESPRIT, Papworth, WHI, WISDOM, Oulu, HABITS and Stockholm trials – not just in early menopausal women, but especially in elderly women, those already at high risk of vascular disease and breast cancer. In elderly overweight women with established vascular and sub-clinical malignant disease, aggravation of these diseases especially with higher doses outweighed the reductions in fractures and colon cancer by such HT.
Up to WW2, there were few hormones, fast foods, TVs, cars or mechanical home / job aids, so most people were far more physically active and slimmer. Since then, technology has both extended life but also increasingly polluted it and reduced necessary exercise – with increasing obesity, feminization of nature , infertility, and consequently more diabetes, vascular disease – and sex hormone imbalance – in both men and women.
But, sixty years of use of physiological human hormone replacement – testosterone in men, estradiol – progesterone – testosterone; and appropriate conservative dose oral hormone therapy orally e.g. premarin + progestin in long term use – as in the Nurses Study, and the WHI and Oulu trials, in younger women – have shown reduced mortality and all aging major degenerative diseases without any significant adverse effects.
So even the world’s leading experts, even in the conservative strictly evidence-based International Menopause Society IMS and the International Society for Study of Aging Males ISSAM concur that there is no reason to withhold appropriate evidence-based HRT of the patient’s choice from hypogonadal men and women, since no individual modern chronic prescription designer drugs do as well.
No modern designer ie synthetic drugs do as well as the natural proven drugs- the supplements of minerals, vitamins and biologicals- including herbs, and many hormones and scores of other biologicals that decline with stress, disease and aging- in preventing, reversing all the common degenerative major diseases of aging. We can rarely completely reverse/ cure sudden death, dementia, stroke, heart failure, type 2 diabetes, cancer, blindness once these occur- but with the long-proven natural drugs that are abundantly and cheaply available, we can more than halve their occurrence , severity and thus disability.
comments and dialogue are welcome.