The promise and proper application of hormone replacement therapy, as well as a dose of myth busting

by Dr. David Suarez

In my experience, one of the most important and successful treatments to prevent disease and the deterioration of aging is Hormone Replacement Therapy (HRT). Defined as medications containing hormones either to supplement naturally occurring hormones or to replace naturally occurring ones, well known applications include replacement therapy during or after menopause to prevent discomfort caused by lowered estrogen and progesterone levels, hormone therapy for prostate cancer patients associated with androgen deprivation therapy, and testosterone replacement in males with low levels due to disease or aging.

Contention within the medical community is ongoing with respect to certain types of these treatments, namely bio-identical hormone replacement therapy (BHRT) vs. Traditional Hormone Replacement Therapy (HRT), and more specifically the latter’s synthetic versions. BHRT uses hormones of the same molecular structure of those made in our bodies, their source (plant based or otherwise) not as significant as their molecular structure. Medical literature supports fewer side effects and complications with BHRT than with synthetic HRT, and the latter has gained an unsavory public reputation since a Women’s Health Initiative trial in 1991 which indicated a link between synthetic hormone therapy and cancer. BHRT, by contrast, is made by both compounding pharmacies and the pharmaceutical industry broadly, and is not only not cancer causing but has been shown to decrease the rate of cancer in some cases.

Current Controversies in BHRT Does Human Growth Hormone (HGH) cause Cancer?
There are only two truly recognized medical indications for the use of HGH, both of which have specific criteria: (1) HGH deficiency in children and adolescents, mainly due to them not growing sufficiently; (2) HGH deficiency in adults from a destructive lesion of the pituitary gland which produces HGH, adults who were growth hormone deficient as children or adolescents, adults who develop deficiency in early adulthood, and AIDS-related wasting.

There have been a number of misleading articles discussing concerns of how recombinant human growth hormone may have a link to causing cancer or increasing its recurrence or progression. A 2002 study published in The Prostate (volume 51, issue 2), however, showed a statistically significant decreased prostate cancer risk with increasing basal levels of HGH.

Does testosterone cause depression?
Testosterone has been shown to help depression and improve mood and quality of life, and in a study published in the Journal of Psychiatric Practice (July 2009; volume 15, issue 4) a comprehensive review showed that testosterone therapy has an antidepressant effect in depressed patients, especially in men with low testosterone levels.

Does testosterone increase cardiovascular risk factors?
There is one main article that most people are aware of in the Journal of American Medical Association, one written by Rebecca Vigen and colleagues, indicating a positive association between testosterone therapy and all-cause mortality, myocardial infarction, and ischemic stroke. Although this article received a lot of publicity and has led to late-night commercials suggesting physician malpractice, it has been retracted and disproved by a number of other studies. In the 1997 Telecom Study, published in the Journal of Clinical Endocrinology & Metabolism, testosterone supplementation was shown to reduce abdominal fat tissue and improve insulin sensitivity in men with low testosterone levels. Other studies have also shown that testosterone administration can lower total and LDL cholesterol. Various medical academies and experts recommend testosterone for cardiovascular protection as well as for quality-of-life benefits.

Does testosterone cause prostate cancer?
Testosterone may cause cancer to grow once prostate cancer is established, but no study shows that testosterone causes cancer. Studies do indicate that higher levels of testosterone are associated with a decreased risk of prostate cancer and less severe types of cancer if one develops, and several recent studies showed that testosterone treatment decreased morbidity and mortality from all causes, including heart disease and all cancers.

Does estrogen and progesterone replacement cause blood clots?
HRT has been promoted by the medical establishment as a means to reduce vasomotor symptoms and decrease postmenopausal health risks. Doctors may be hesitant to prescribe it due to fear generated by the Women’s Health Initiative study in 1991 mentioned above, which demonstrated an increased risk of breast cancer, heart disease, and stroke in women who were treated with the synthetic hormone combination of Premarin and Provera. This study does not apply to bio-identical hormones, however, which have different molecular structures, metabolites, and biological effects than the hormones studied in the WHI report. This dissimilarity is not understood by many physicians, journalists, and the lay public.

— Dr. Suarez, a board-certified general surgeon, practices at Fountain of Youth RX and administers hormone replacement therapy as a part of that practice.

Fountain of Youth RX
3733 Richmond Avenue, Suite 1A / 718.215.9531 / fountainofyouthrx.com