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Healthy Aging

Dr. Wulf Utian Speaks Out on Hormone Therapy

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Unnecessary premature death as a consequence of the WHI study

by Wulf H. Utian, MD, BCh, PhD, DSc(Med), FRCOG, FACOG, FICS

It is never ever pleasant in the practice of medicine to live to see a health warning you issued become fact.

In July 2002, right after the infamous press conference held by the NIH to announce the premature termination of the estrogen-progestogen arm of the Women’s Health Initiative study (WHI) and warn women off taking postmenopausal hormones, I wrote an editorial in Menopause Management saying: “While the merits and demerits of the data and the wisdom of the decision to terminate this arm of the WHI study will be debated for years, the manner in which the study was terminated was poorly planned, abrupt and inhumane. Predictably, the media response was enormous, ranging from thoughtful to sensational.”1

Despite their own evidence showing a nonstatistically significant increase in breast cancer, the results were exaggerated to achieve maximum impact and terrify women.

Ten years later, as the deleterious effects on women’s health were becoming quite alarming, I wrote a key paper2 stating “literally millions of women discontinued hormone use after the dramatic announcement by NIH in 2002.

The real story of the WHI may turn out to be incalculable damage wrought on younger peri- and early postmenopausal women who discontinued their therapy and who are now several years beyond menopause and off hormones. Not only have they have suffered through menopause-related symptoms, but the very women who might have been protected from heart disease, the single biggest killer of women over 50, and osteoporosis, one of the most significant causes of long-term disability, are the ones potentially most damaged by the WHI.

Women who discontinued postmenopausal hormone therapy (PHT) have significantly increased risk of hip fracture compared with women who continued taking hormone therapy (HT).3 Indeed, there are estimates that discontinuation of PHT may have resulted in over 43,000 bone fractures per year in the USA. The number of increased cardiovascular events in young women who discontinued ET may be even more staggering. Publications from the WHI clearly demonstrate no increase in cardiovascular risk in women aged 50-59, and indeed, for the first time ever, an intervention, namely estrogen, has been demonstrated to actually reduce calcified plaque burden in the coronary arteries of these women. Even statins have not been demonstrated to be this effective in women.”2

Now a new scientific study recently released online ahead of print reports that over a 10-year span, starting in 2002, a minimum of 18,601 and as many as 91,610 postmenopausal women died prematurely because of the avoidance of estrogen therapy.4

This situation is outrageous. Deaths of women in America as a result of fear of postmenopausal hormone therapy now equate to losses in the wars in Iraq and Afghanistan. How many more women must suffer before the WHI investigators call another press conference and repudiate their own warnings? Or what does it take for our government to open an inquiry into the real results of the billion-dollar WHI study?

There is urgency and a necessity for women to hear the truth and take appropriate actions to enhance the duration and quality of their lives.

Speak out!

Wulf Utian, MD, PhD, DSc, is author of  Change Your Menopause – Why one size does not fit all, available at http://www.amazon.com/Change-Your-Menopause-size-does/dp/0982845723/. He is an independent consultant in women's health issues and is a world renowned expert on menopause. Dr. Utian is the executive director emeritus and honorary founding president of The North American Menopause Society.

References
1. Utian WH: Managing Menopause After HERS II and WHI: Coping with the Aftermath. Menopause Management, July 2002,Vol. 11 – No. 4.
2. Utian WH. A decade post WHI, menopausal hormone therapy comes full circle – need for an independent commission. Climacteric 2012;15:320.
3. Karim R, Dell RM, Greene DF, Mack WJ, Gallagher JC and Hodis HN. Hip fracture in postmenopausal women after cessation of hormone therapy: results from a large health management organization. Menopause 2011;18:1172-1177.
4. Sarrel PM, Njike VY, Vinante V and Katz DL. The mortality toll of estrogen avoidance: An analysis of excess deaths among hysterectomized women aged 50 to 59 years. Am J Public Hlth. Published online ahead of print.

Comments

Since I was taken off estrogene for complete hysterectomy since 1983 at 36. Had complete right knee replacement 3/2010, now right hip Bone on Bone over past 3 years. I have chronic pain & have had numerous reactions to many blood pressure Meds Beta blockers and others I can't recall through my 35+ years with HMO Kaiser . I have been diagnosed Bipolar &, PTSD after disability retirement with Santa Clara County 911 , with full benefits after 20years employed. I have had rare extensive medical problems with Puesdo Tumor,Papiladema, grapefruit size Fibroid with removal of one ovary on high risk pregnancy bleed full 9 months after C-Section birth of daughter 1981, followed by complete Hysterectomy, 1986,due to sever irregular mentration. Had Gall bladder removal 1987. I am at my wits end reading & trying to find out was is wrong with me, also have Sleep Apnea, unable to use C-Pap due to flash backs on PTSD from High stress 911 with no psych on duty on site untill I got seriously Iill after 20 years Dispatch 911 San Jose Police from Stress a real killer. Planning on scheduling Naturalpath for $1000 to treat me extensivelywith Labs,Sensitivity and Supplements who was 2012 awarded ND physician here in Sacramento, Ca. It's been a frustrating 20 years Psychiatric&Medical nitghtmare, will be 65, 9/18/48.. Don't know if you be of any help from all the nightmares you help .Today i watched fanotchthe top expert in Alzheimer & Clinical Professor of UCLA,. Worry this is going to happen to me since 89 year old Father diagnosed with Vascular Dementia, with progressing stages. My health has Burden my 38yr marriage & 32year old Daughter, who is OUR Cartaker while Husband 74 with Diabetis, &Stroke African American & I Hispanic. My home, 7467 Sun Castle Ln., Sacramento,Ca., 95823, 916 942-9045 or. Cell 209 598-1985, e-mail / [email protected] Thank you for reading my life history. if there is anything you can do.
PLEASE CONTACT ME

Had to write to you.. As your story sounds much like mine..I went through hell..
Don't let anyone tell you that a complete ovary removal will NOT cause you mental distress. It can and many times it will snowball..
Its called "menaStop" for a reason..
Hormones are chemical messengers and effect you mentally.. The stress and the miserable lack of sleep and the effect on you mentally can turn into sleep distress and depression..
YOur body and your mind have been speaking to each other since you started your periods..Through chemical messengers called hormones…Estrogen progesterone and testosterone…. This sudden end to that is traumatic for many many women.
I would say.. Get on estrogen. Not premarin.. But estrace.. The doctor played hormone roulette with me..As I spiraled more and more down hill.. The more he played with the hormones... I knew it was not right from day one..AS he gave me premarin. Which is HORSE estrogen.. .( hardly a replacement for human estrogen) ~!
He had given me progesterone also right after the surgery, and stopped it in 6 weeks, when he found I did not have endometriosis.. Just stopped it.. It was a shock to my body. Then when I kept having problems and he could not seem to "adjust" a dose to fit my needs.. HE simply decided I should go without, leaving me with none.. To start from scratch as he put it..~!
I knew I was very badly effected by this hormone loss from day one. I could not sleep..I could not settle into a feeling of being "OK" and I finally was put on anti depressants, anti anxiety and Still I was not OK..
I was hospitalized..
Sent to a hormone specialist who took one look and said.. YOU do not need all this, you need hormones.The right ones..
I got esterace.. 2 mg and In about 4 days I KNEW at least some part of this hell was over.. I was not exactly feeling well. But I felt my body accept the hormone and some part of the problem was taken care of.
It took many months to adjust..
And many years of anti depressants to help me get over the depression the whole drama caused.
I will fight for estrogen..
As the doctors want to play with it again as I too am in my 60's.
I am not willing to be put through menopause again.. I am not willing to take this long long road down hill again..
I never stopped taking estrace.. I fight and I fight for them. As I am terrified of being put through mental hell again.
The truth is , some women are more sensitive to hormone imbalance, more sensitive to hormone loss.. and fluctuations..
Post partum depression is caused by fluctuating hormones.. PMS .etc..
Don't let anyone tell you.that a sudden loss of hormones can not put you in a downward spiral..
Because for some women it most certainly can and it does.

Well now this is something that would not come in to existence as long as it is experimented first. a lot of people have dedicated their lives on such research and thus it is a sure shot success as far as I can tell. EMR

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