FDA removed black box warning for HRT

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

The only thing that “fixes” a frozen shoulder is time. You can’t do anything with a frozen shoulder that is useful until it reaches the “unfreezing” stage.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

It does not always have to do with movement. Your answer is focused on the one area you know and that is a problem.

Women are more prone to frozen shoulder, for example. They don’t quite know why but low estrogen is suspected.

If men get frozen shoulder, they often have diabetes or a thyroid problem, too. So, they do get it but there is no proof it is from lack of movement.

Although estrogen seems to be connected to joint pain, the impact of HRTs is very small. You’re still going to need to exercise and lose weight as the primary way to handle joint and muscle issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

The only thing that “fixes” a frozen shoulder is time. You can’t do anything with a frozen shoulder that is useful until it reaches the “unfreezing” stage.

That wasn’t my experience. I had two frozen shoulders in a row and the second one healed much more quickly with aggressive PT that included weight lifting (not just tiny stretches). More importantly, consistent lifting totally healed both shoulders so I can swim again. The first shoulder lingered with pain and reduced range of motion for years; the second one (treated with strength training) healed much more quickly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

It does not always have to do with movement. Your answer is focused on the one area you know and that is a problem.

Women are more prone to frozen shoulder, for example. They don’t quite know why but low estrogen is suspected.

If men get frozen shoulder, they often have diabetes or a thyroid problem, too. So, they do get it but there is no proof it is from lack of movement.

Although estrogen seems to be connected to joint pain, the impact of HRTs is very small. You’re still going to need to exercise and lose weight as the primary way to handle joint and muscle issues.

I’m not overweight and already exercise, so that won’t work for me.

My MD suggested HRT and it works for me. My endocrinologist is quite happy with the results of my DEXA.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

The only thing that “fixes” a frozen shoulder is time. You can’t do anything with a frozen shoulder that is useful until it reaches the “unfreezing” stage.

That wasn’t my experience. I had two frozen shoulders in a row and the second one healed much more quickly with aggressive PT that included weight lifting (not just tiny stretches). More importantly, consistent lifting totally healed both shoulders so I can swim again. The first shoulder lingered with pain and reduced range of motion for years; the second one (treated with strength training) healed much more quickly.

I also had two frozen shoulders and weightlifting caused more pain. The PT with a doctorate said I could keep doing PT during the frozen stage if I really wanted (PT does not work well in the frozen stage) but I might want to wait until the unfreezing.

It’s in the science that frozen shoulder does not heal until the unfreezing stage.

It is likely you were in the unfreezing stage when weightlifting “worked” and still in the freezing or frozen stage when it did not.

And, yes, it’s true that strength training helps “after,” which is the unfreezing or unfrozen stage, to increase rom.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

It does not always have to do with movement. Your answer is focused on the one area you know and that is a problem.

Women are more prone to frozen shoulder, for example. They don’t quite know why but low estrogen is suspected.

If men get frozen shoulder, they often have diabetes or a thyroid problem, too. So, they do get it but there is no proof it is from lack of movement.

Although estrogen seems to be connected to joint pain, the impact of HRTs is very small. You’re still going to need to exercise and lose weight as the primary way to handle joint and muscle issues.

I’m not overweight and already exercise, so that won’t work for me.

My MD suggested HRT and it works for me. My endocrinologist is quite happy with the results of my DEXA.

Yet you still need to exercise and maintain a healthy weight. HRT is not removing your joint pain. The research shows a very modest if that impact. Exercising more (adding swimming, yoga, weights) likely would have as much or the same impact. With no side effects and many more benefits.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

The only thing that “fixes” a frozen shoulder is time. You can’t do anything with a frozen shoulder that is useful until it reaches the “unfreezing” stage.

That wasn’t my experience. I had two frozen shoulders in a row and the second one healed much more quickly with aggressive PT that included weight lifting (not just tiny stretches). More importantly, consistent lifting totally healed both shoulders so I can swim again. The first shoulder lingered with pain and reduced range of motion for years; the second one (treated with strength training) healed much more quickly.

I also had two frozen shoulders and weightlifting caused more pain. The PT with a doctorate said I could keep doing PT during the frozen stage if I really wanted (PT does not work well in the frozen stage) but I might want to wait until the unfreezing.

It’s in the science that frozen shoulder does not heal until the unfreezing stage.

It is likely you were in the unfreezing stage when weightlifting “worked” and still in the freezing or frozen stage when it did not.

And, yes, it’s true that strength training helps “after,” which is the unfreezing or unfrozen stage, to increase rom.

Ffs that is not “the science.” But feel free to post a link to “the science” supporting that taking HRT is more effective than exercise/PT.

FWIW I was doing PT and strength training the whole course of the frozen shoulder. My very excellent DPT was quite insistent that I do strength exercises like overhead presses even when in pain. She explained that guarding the joint during the painful phase is actually what causes greater loss of ROM down the line.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

I workout every day, lifting 3x per week. One year ago, the weirdest joint pains were causing me to lose sleep and move slower. One hip. One big toe. Add in the sleep issues, noise sensitivity, rage days, and hot flashes/night sweats. It was miserable and had nothing to do with not being active or my macros. Thankfully, my doctor knew what was up and prescribed the patch and progesterone pill.

Six weeks into HRT, it was gone. Five months in, I felt like my old self.

Please consider that you don’t know what everyone is experiencing and you sure as hell aren’t smarter than the experienced physicians.

My aging husband has more “menopause” symptoms than me.

Well forget medical studies and data then! Because this here couple is having this here experience! Who needs research, I guess

Attributing many of the symptoms of aging to menopause is goofy.

Are you really refusing to consider the (copious) data that shows that rapid loss of estrogen makes many of those symptoms worse, and faster?

Again, don't take HRT if you don't want to. Some women can't, some women don't want to. And that's great! Yay for choice! Yay for informed decisions! I just find it so bewildering that PP/s would be so committed to their own lack of information.

Not everyone wants to overestimate the impacts of menopause in aging.

Or make it their identity.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

I workout every day, lifting 3x per week. One year ago, the weirdest joint pains were causing me to lose sleep and move slower. One hip. One big toe. Add in the sleep issues, noise sensitivity, rage days, and hot flashes/night sweats. It was miserable and had nothing to do with not being active or my macros. Thankfully, my doctor knew what was up and prescribed the patch and progesterone pill.

Six weeks into HRT, it was gone. Five months in, I felt like my old self.

Please consider that you don’t know what everyone is experiencing and you sure as hell aren’t smarter than the experienced physicians.

My aging husband has more “menopause” symptoms than me.

Well forget medical studies and data then! Because this here couple is having this here experience! Who needs research, I guess

Attributing many of the symptoms of aging to menopause is goofy.

No it’s not. Loss of estrogen has health implications.

Some health implications.

A lot of it is just aging.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ huh?

What made you stop exercising pre-HRT?

I’ve been an athlete my entire life and workout 6 days/week and I’m 55- no HRT.

Just curious to what was correlated w/ your inability to exercise pre-HRT and what changed after it

So much joint pain, stiffness like I’ve never had in my life, quick to injure myself, and recovery took forever. Felt like I was moving like the walking dead. Constant PT.

Estrogen has made movement easier — like my joints and muscles are more supple. Apparently musculoskeletal effects are a big issue in some menopausal women. Apparently I am one of them.

Are you telling me that aging men don’t experience joint pain and stiffness? Most of the comments make zero sense. It’s not all about estrogen. When you stop moving, you become move stiff. You exacerbated your problems by dropping exercise:

As someone who didn’t stop, the joint pain and inflammation is real and is beyond just “aging” that can compare to men getting as well. For those going through frozen shoulder and other menopausal events, your pain is real and comments from others can be hurtful.

I had two frozen shoulders and fixed them through a slow process of weight lifting and increasing activity. The fact is, the impact of HRT on joint pain (even if it exists) is likely MUCH less than exercise and diet. There is no easy fix and HRT is clearly being marketed towards American women gullible enough to believe that there is. The only easy fix in medicine right now is probably GLPs.

The only thing that “fixes” a frozen shoulder is time. You can’t do anything with a frozen shoulder that is useful until it reaches the “unfreezing” stage.

That wasn’t my experience. I had two frozen shoulders in a row and the second one healed much more quickly with aggressive PT that included weight lifting (not just tiny stretches). More importantly, consistent lifting totally healed both shoulders so I can swim again. The first shoulder lingered with pain and reduced range of motion for years; the second one (treated with strength training) healed much more quickly.

I also had two frozen shoulders and weightlifting caused more pain. The PT with a doctorate said I could keep doing PT during the frozen stage if I really wanted (PT does not work well in the frozen stage) but I might want to wait until the unfreezing.

It’s in the science that frozen shoulder does not heal until the unfreezing stage.

It is likely you were in the unfreezing stage when weightlifting “worked” and still in the freezing or frozen stage when it did not.

And, yes, it’s true that strength training helps “after,” which is the unfreezing or unfrozen stage, to increase rom.

Ffs that is not “the science.” But feel free to post a link to “the science” supporting that taking HRT is more effective than exercise/PT.

FWIW I was doing PT and strength training the whole course of the frozen shoulder. My very excellent DPT was quite insistent that I do strength exercises like overhead presses even when in pain. She explained that guarding the joint during the painful phase is actually what causes greater loss of ROM down the line.

+1

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the people who think hormone replacement therapy is just a grift from the wellness industry why aren’t you looking at the other side of the grift? It’s not as if women who don’t choose hormone replacement theory are aging naturally, lol

I’m a healthcare policy walk who can answer any question on Medicare spend and is deep on the data of what happens to aging women in America. Anyone who says women are aging naturally are either deeply delusional or deeply denial and throw in a dose of deeply ignorant.

Do you have any idea of the number of postmenopausal women who are on antidepressants, anti-anxiety meds, prescriptions sleep aids, hypertension drugs, statins, osteoporosis medications, treatments for UTI, treatments for sexual dysfunction, and the list goes on. Not to mention the care that we spend on frailty from hip fractures, chronic pain meds from bone breaks, hospitalizations caused from UTIs in older women and again the list goes on.

Do you know a lot of dentists will not treat women who are on osteoporosis meds beyond basic cleanings because the mortality rate for any kind of dental surgery for women on these meds is so high? Have you thought about what might happen if you need to go on osteoporosis meds, and something happens to your dental health. You probably should.

While I agree that the evidence does not seem to be there to just put every woman on HRT for primary prevention - if women are having symptoms there does seem to be good evidence that it does help prevent the need for some of these other medical conditions.

I’d be very wary of anyone trying to stop any kind of discourse on HRT. It’s just a grift on the other side and frankly, the spend is a lot higher than what we would spend on HRT. Again, I will stress that I do not think every woman should be on HRT, but to not even entertain the need for research and do not even question The bad advice women got 25 years ago from a deeply flawed that has been retracted, there’s something really disturbing going on there.

There’s zero evidence that HRT’s “prevent” all the things you listed. HRTs are very effective for one thing - hot flashes. There is good evidence for osteoporosis. But women are still going to need statins, SSRIs, therapy, blood pressure meds, even when HRT.

It's important to pause here to distinguish between indication (what offical approval does the therapy have) and effectiveness, as well as the standards of evidence for treatment vs. prevention.

HRT is indicated for the *treatment* of hot flashes and other vasomotor symptoms, genitourinary symptoms, osteoporosis, and other issues related to estrogen deficiency. It is also indicated for the *prevention* of osteoporosis in at-risk postmenopausal women. It has both treatment and prevention indication for osteoporosis, because the biological mechanism is direct and clear (and has been confirmed in every major study).

But it's much harder to get preventive indications when biological mechanisms aren't direct, and/or don't apply equally to all populations-- for example, cardiovascular disease and type 2 diabetes. These diseases are complex, and they involve multiple pathways. So it's much, much harder to meet a blanket indication standard. That said, multiple randomized trials and meta analyses do suggest quite strongly that HRT helps prevent type 2 diabetes. And newer trials and re-analysis of the women's health initiative (removing women who had already developed heart disease, for example) offer evidence that women who begin HRT before 60 have lower rates of heart-disease and all-cause mortality. But because the data are more complex and more nuanced, the FDA can’t write a blanket approval for prevention the way it can for treating hot flashes or preserving bone.

TLDR: Evidence is not the same thing as approval. I think that's partly what makes this discussion so challenging.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To the people who think hormone replacement therapy is just a grift from the wellness industry why aren’t you looking at the other side of the grift? It’s not as if women who don’t choose hormone replacement theory are aging naturally, lol

I’m a healthcare policy walk who can answer any question on Medicare spend and is deep on the data of what happens to aging women in America. Anyone who says women are aging naturally are either deeply delusional or deeply denial and throw in a dose of deeply ignorant.

Do you have any idea of the number of postmenopausal women who are on antidepressants, anti-anxiety meds, prescriptions sleep aids, hypertension drugs, statins, osteoporosis medications, treatments for UTI, treatments for sexual dysfunction, and the list goes on. Not to mention the care that we spend on frailty from hip fractures, chronic pain meds from bone breaks, hospitalizations caused from UTIs in older women and again the list goes on.

Do you know a lot of dentists will not treat women who are on osteoporosis meds beyond basic cleanings because the mortality rate for any kind of dental surgery for women on these meds is so high? Have you thought about what might happen if you need to go on osteoporosis meds, and something happens to your dental health. You probably should.

While I agree that the evidence does not seem to be there to just put every woman on HRT for primary prevention - if women are having symptoms there does seem to be good evidence that it does help prevent the need for some of these other medical conditions.

I’d be very wary of anyone trying to stop any kind of discourse on HRT. It’s just a grift on the other side and frankly, the spend is a lot higher than what we would spend on HRT. Again, I will stress that I do not think every woman should be on HRT, but to not even entertain the need for research and do not even question The bad advice women got 25 years ago from a deeply flawed that has been retracted, there’s something really disturbing going on there.

There’s zero evidence that HRT’s “prevent” all the things you listed. HRTs are very effective for one thing - hot flashes. There is good evidence for osteoporosis. But women are still going to need statins, SSRIs, therapy, blood pressure meds, even when HRT.

It's important to pause here to distinguish between indication (what offical approval does the therapy have) and effectiveness, as well as the standards of evidence for treatment vs. prevention.

HRT is indicated for the *treatment* of hot flashes and other vasomotor symptoms, genitourinary symptoms, osteoporosis, and other issues related to estrogen deficiency. It is also indicated for the *prevention* of osteoporosis in at-risk postmenopausal women. It has both treatment and prevention indication for osteoporosis, because the biological mechanism is direct and clear (and has been confirmed in every major study).

But it's much harder to get preventive indications when biological mechanisms aren't direct, and/or don't apply equally to all populations-- for example, cardiovascular disease and type 2 diabetes. These diseases are complex, and they involve multiple pathways. So it's much, much harder to meet a blanket indication standard. That said, multiple randomized trials and meta analyses do suggest quite strongly that HRT helps prevent type 2 diabetes. And newer trials and re-analysis of the women's health initiative (removing women who had already developed heart disease, for example) offer evidence that women who begin HRT before 60 have lower rates of heart-disease and all-cause mortality. But because the data are more complex and more nuanced, the FDA can’t write a blanket approval for prevention the way it can for treating hot flashes or preserving bone.

TLDR: Evidence is not the same thing as approval. I think that's partly what makes this discussion so challenging.

I don’t disagree with what you wrote. I was responding to the PP who seemed to be trying to claim that HRT can replace the medications/therapies/lifestyle interventions for basically all chronic diseases. No. Even if HRT has some protective effect on heart disease, depression, diabetes, joint pain, etc, women will still need to take statins, GLPs, SSRIs, get therapy, etc. it doesn’t cure any of those things, even in the most positive of trials.

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the people who think hormone replacement therapy is just a grift from the wellness industry why aren’t you looking at the other side of the grift? It’s not as if women who don’t choose hormone replacement theory are aging naturally, lol

I’m a healthcare policy walk who can answer any question on Medicare spend and is deep on the data of what happens to aging women in America. Anyone who says women are aging naturally are either deeply delusional or deeply denial and throw in a dose of deeply ignorant.

Do you have any idea of the number of postmenopausal women who are on antidepressants, anti-anxiety meds, prescriptions sleep aids, hypertension drugs, statins, osteoporosis medications, treatments for UTI, treatments for sexual dysfunction, and the list goes on. Not to mention the care that we spend on frailty from hip fractures, chronic pain meds from bone breaks, hospitalizations caused from UTIs in older women and again the list goes on.

Do you know a lot of dentists will not treat women who are on osteoporosis meds beyond basic cleanings because the mortality rate for any kind of dental surgery for women on these meds is so high? Have you thought about what might happen if you need to go on osteoporosis meds, and something happens to your dental health. You probably should.

While I agree that the evidence does not seem to be there to just put every woman on HRT for primary prevention - if women are having symptoms there does seem to be good evidence that it does help prevent the need for some of these other medical conditions.

I’d be very wary of anyone trying to stop any kind of discourse on HRT. It’s just a grift on the other side and frankly, the spend is a lot higher than what we would spend on HRT. Again, I will stress that I do not think every woman should be on HRT, but to not even entertain the need for research and do not even question The bad advice women got 25 years ago from a deeply flawed that has been retracted, there’s something really disturbing going on there.

There’s zero evidence that HRT’s “prevent” all the things you listed. HRTs are very effective for one thing - hot flashes. There is good evidence for osteoporosis. But women are still going to need statins, SSRIs, therapy, blood pressure meds, even when HRT.

Wait. Didn’t you know that HRT is the cure all for anything that happens after you turn 40?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To the people who think hormone replacement therapy is just a grift from the wellness industry why aren’t you looking at the other side of the grift? It’s not as if women who don’t choose hormone replacement theory are aging naturally, lol

I’m a healthcare policy walk who can answer any question on Medicare spend and is deep on the data of what happens to aging women in America. Anyone who says women are aging naturally are either deeply delusional or deeply denial and throw in a dose of deeply ignorant.

Do you have any idea of the number of postmenopausal women who are on antidepressants, anti-anxiety meds, prescriptions sleep aids, hypertension drugs, statins, osteoporosis medications, treatments for UTI, treatments for sexual dysfunction, and the list goes on. Not to mention the care that we spend on frailty from hip fractures, chronic pain meds from bone breaks, hospitalizations caused from UTIs in older women and again the list goes on.

Do you know a lot of dentists will not treat women who are on osteoporosis meds beyond basic cleanings because the mortality rate for any kind of dental surgery for women on these meds is so high? Have you thought about what might happen if you need to go on osteoporosis meds, and something happens to your dental health. You probably should.

While I agree that the evidence does not seem to be there to just put every woman on HRT for primary prevention - if women are having symptoms there does seem to be good evidence that it does help prevent the need for some of these other medical conditions.

I’d be very wary of anyone trying to stop any kind of discourse on HRT. It’s just a grift on the other side and frankly, the spend is a lot higher than what we would spend on HRT. Again, I will stress that I do not think every woman should be on HRT, but to not even entertain the need for research and do not even question The bad advice women got 25 years ago from a deeply flawed that has been retracted, there’s something really disturbing going on there.

There’s zero evidence that HRT’s “prevent” all the things you listed. HRTs are very effective for one thing - hot flashes. There is good evidence for osteoporosis. But women are still going to need statins, SSRIs, therapy, blood pressure meds, even when HRT.

Wait. Didn’t you know that HRT is the cure all for anything that happens after you turn 40?

You’re quick with the one liners. That probably feels very satisfying.

One-liners aside, there’s actually ample evidence that HRT helps with the things mentioned. You, too, can look up the studies and meta analyses; some have even been posted in this thread.

But you don’t have to read them! It is absolutely your choice to ignore them and go straight to the next one-liner. Wishing you a good night either way,

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To the people who think hormone replacement therapy is just a grift from the wellness industry why aren’t you looking at the other side of the grift? It’s not as if women who don’t choose hormone replacement theory are aging naturally, lol

I’m a healthcare policy walk who can answer any question on Medicare spend and is deep on the data of what happens to aging women in America. Anyone who says women are aging naturally are either deeply delusional or deeply denial and throw in a dose of deeply ignorant.

Do you have any idea of the number of postmenopausal women who are on antidepressants, anti-anxiety meds, prescriptions sleep aids, hypertension drugs, statins, osteoporosis medications, treatments for UTI, treatments for sexual dysfunction, and the list goes on. Not to mention the care that we spend on frailty from hip fractures, chronic pain meds from bone breaks, hospitalizations caused from UTIs in older women and again the list goes on.

Do you know a lot of dentists will not treat women who are on osteoporosis meds beyond basic cleanings because the mortality rate for any kind of dental surgery for women on these meds is so high? Have you thought about what might happen if you need to go on osteoporosis meds, and something happens to your dental health. You probably should.

While I agree that the evidence does not seem to be there to just put every woman on HRT for primary prevention - if women are having symptoms there does seem to be good evidence that it does help prevent the need for some of these other medical conditions.

I’d be very wary of anyone trying to stop any kind of discourse on HRT. It’s just a grift on the other side and frankly, the spend is a lot higher than what we would spend on HRT. Again, I will stress that I do not think every woman should be on HRT, but to not even entertain the need for research and do not even question The bad advice women got 25 years ago from a deeply flawed that has been retracted, there’s something really disturbing going on there.

There’s zero evidence that HRT’s “prevent” all the things you listed. HRTs are very effective for one thing - hot flashes. There is good evidence for osteoporosis. But women are still going to need statins, SSRIs, therapy, blood pressure meds, even when HRT.

Wait. Didn’t you know that HRT is the cure all for anything that happens after you turn 40?

You’re quick with the one liners. That probably feels very satisfying.

One-liners aside, there’s actually ample evidence that HRT helps with the things mentioned. You, too, can look up the studies and meta analyses; some have even been posted in this thread.

But you don’t have to read them! It is absolutely your choice to ignore them and go straight to the next one-liner. Wishing you a good night either way,

I also don’t get the snark or why this topic is so polarizing. It doesn’t have to be black and white - women curious or interested in symptom relief or making perimenopause and menopause easier or even age better to stay out of the nursing home doesn’t mean they all want to be 20 again.