Anonymous wrote:

Anonymous wrote:For those who want data and official medical positions, here's some research on HRT and type 2 diabetes. Summarizing, it shows that across multiple large randomized trials and meta-analyses, HRT with estrogen (with or without progestin) reduces the risk of developing type 2 diabetes on the order of 20–30% and improves insulin resistance and glucose control:

Margolis KL et al., Diabetologia 2004 — 15,641 postmenopausal women randomized and placebo controlled: https://link.springer.com/article/10.1007/s00125-004-1448-x

Mauvais-Jarvis et al. 2017 – Endocrine Reviews
https://academic.oup.com/edrv/article/38/3/173/3063786

Note that HRT does not have an FDA-approved prevention indication.

The North American Menopause Society in their 2022 position statement said that they do NOT recommend starting HRT primarily to prevent diabetes, but that a diabetes-preventive effect is a real, evidence-based benefit in appropriate women (younger, early postmenopause): https://pubmed.ncbi.nlm.nih.gov/35797481/

Sure. But since we are being so detailed about the absolute of HRT it is also important to be detailed about the absolute benefits: “The cumulative incidence of treated diabetes was 3.5% in the hormone therapy group and 4.2%”

So there was 0.7% fewer diabetes cases in the HRT group. Hardly a stunning number on an individual level. These findings are probably most important to conclude that a woman with diabetes or at risk of it can take HRT without a negative impact on diabetes.

Anonymous wrote:For those who want data and official medical positions, here's some research on HRT and type 2 diabetes. Summarizing, it shows that across multiple large randomized trials and meta-analyses, HRT with estrogen (with or without progestin) reduces the risk of developing type 2 diabetes on the order of 20–30% and improves insulin resistance and glucose control:

Margolis KL et al., Diabetologia 2004 — 15,641 postmenopausal women randomized and placebo controlled: https://link.springer.com/article/10.1007/s00125-004-1448-x

Mauvais-Jarvis et al. 2017 – Endocrine Reviews
https://academic.oup.com/edrv/article/38/3/173/3063786

Note that HRT does not have an FDA-approved prevention indication.

The North American Menopause Society in their 2022 position statement said that they do NOT recommend starting HRT primarily to prevent diabetes, but that a diabetes-preventive effect is a real, evidence-based benefit in appropriate women (younger, early postmenopause): https://pubmed.ncbi.nlm.nih.gov/35797481/

Anonymous wrote:

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.

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.

But no one wrote that. You’ve misinterpreted that post, per your apparent usual.

Are you a researcher or a physician?

Anonymous wrote:

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.

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.

But no one wrote that. You’ve misinterpreted that post, per your apparent usual.

Are you a researcher or a physician?

Anonymous wrote:

Anonymous wrote:I was all for HRT. I started taking it last year and this year I got diagnosed with hormone positive breast cancer with no family or genetic history. I’m not anti HRT even now but I do wonder if the timing was suspicious? I’m pretty bummed that not only can I never use it again but now I have to be on a hormone blocker for at least 5 years.

Hm.
Really.

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.

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 wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don’t trust anything RFK jr or trump says. This FDA is currently SUS so I’m seeing this as a red flag. If they promote it, I should not consider it.
If it was legitimately safe, Melania should have made the announcement. Woman to women.
I’ll wait until we have actual medical experts back in the FDA before I trust their advice.

Wow - you would have given it more credence out of Melania’s mouth? That’s moronic.

HRT has enabled me to sleep through the night regularly for the first time in a year. Game changer.

And has increased your risk of stroke and cancer.

Well, my thyroid stopped working in my 20s and I need thyroid replacement hormone for the rest of my life to function because my body doesn’t make thyroid hormone anymore. Does that raise my risk of stroke and cancer? I don’t know, maybe. But I’d rather die than live half dead. I don’t see how it’s different with progesterone and estrogen.

Having had hormone positive breast cancer and a double mastectomy, I beg to differ.

Then it’s not for you. So step off.

I’m not in a breast cancer thread. You’re here for what purpose? Did you take HRT and then have your double mastectomy? No, right? STFU.

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,

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don’t trust anything RFK jr or trump says. This FDA is currently SUS so I’m seeing this as a red flag. If they promote it, I should not consider it.
If it was legitimately safe, Melania should have made the announcement. Woman to women.
I’ll wait until we have actual medical experts back in the FDA before I trust their advice.

Wow - you would have given it more credence out of Melania’s mouth? That’s moronic.

HRT has enabled me to sleep through the night regularly for the first time in a year. Game changer.

And has increased your risk of stroke and cancer.

Well, my thyroid stopped working in my 20s and I need thyroid replacement hormone for the rest of my life to function because my body doesn’t make thyroid hormone anymore. Does that raise my risk of stroke and cancer? I don’t know, maybe. But I’d rather die than live half dead. I don’t see how it’s different with progesterone and estrogen.

Having had hormone positive breast cancer and a double mastectomy, I beg to differ.

Then you are not a good candidate for HRT. Just like anyone who has had cancer or has a family risk for cancers.

But for many people, it's a viable solution to the problem and the benefits outweigh the risks

The risk is cancer. So, no.

And NOT taking HRT raises your risk of colorectal cancer.

Like it or not, there is no risk-free path. I wish there were.

I wish you peace, which is what I suspect you are seeking.

I don’t think she’s seeking peace. I think she’s searching for fights and is at unusually high risk for being beaten to death with a bag of satsumas in a Whole Foods parking lot.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don’t trust anything RFK jr or trump says. This FDA is currently SUS so I’m seeing this as a red flag. If they promote it, I should not consider it.
If it was legitimately safe, Melania should have made the announcement. Woman to women.
I’ll wait until we have actual medical experts back in the FDA before I trust their advice.

Wow - you would have given it more credence out of Melania’s mouth? That’s moronic.

HRT has enabled me to sleep through the night regularly for the first time in a year. Game changer.

And has increased your risk of stroke and cancer.

Well, my thyroid stopped working in my 20s and I need thyroid replacement hormone for the rest of my life to function because my body doesn’t make thyroid hormone anymore. Does that raise my risk of stroke and cancer? I don’t know, maybe. But I’d rather die than live half dead. I don’t see how it’s different with progesterone and estrogen.

Having had hormone positive breast cancer and a double mastectomy, I beg to differ.

Then you are not a good candidate for HRT. Just like anyone who has had cancer or has a family risk for cancers.

But for many people, it's a viable solution to the problem and the benefits outweigh the risks

The risk is cancer. So, no.

And NOT taking HRT raises your risk of colorectal cancer.

Like it or not, there is no risk-free path. I wish there were.

I wish you peace, which is what I suspect you are seeking.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don’t trust anything RFK jr or trump says. This FDA is currently SUS so I’m seeing this as a red flag. If they promote it, I should not consider it.
If it was legitimately safe, Melania should have made the announcement. Woman to women.
I’ll wait until we have actual medical experts back in the FDA before I trust their advice.

Wow - you would have given it more credence out of Melania’s mouth? That’s moronic.

HRT has enabled me to sleep through the night regularly for the first time in a year. Game changer.

And has increased your risk of stroke and cancer.

Well, my thyroid stopped working in my 20s and I need thyroid replacement hormone for the rest of my life to function because my body doesn’t make thyroid hormone anymore. Does that raise my risk of stroke and cancer? I don’t know, maybe. But I’d rather die than live half dead. I don’t see how it’s different with progesterone and estrogen.

Having had hormone positive breast cancer and a double mastectomy, I beg to differ.

Then it’s not for you. So step off.

I’m not in a breast cancer thread. You’re here for what purpose? Did you take HRT and then have your double mastectomy? No, right? STFU.

Anonymous wrote:I was all for HRT. I started taking it last year and this year I got diagnosed with hormone positive breast cancer with no family or genetic history. I’m not anti HRT even now but I do wonder if the timing was suspicious? I’m pretty bummed that not only can I never use it again but now I have to be on a hormone blocker for at least 5 years.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don’t trust anything RFK jr or trump says. This FDA is currently SUS so I’m seeing this as a red flag. If they promote it, I should not consider it.
If it was legitimately safe, Melania should have made the announcement. Woman to women.
I’ll wait until we have actual medical experts back in the FDA before I trust their advice.

Wow - you would have given it more credence out of Melania’s mouth? That’s moronic.

HRT has enabled me to sleep through the night regularly for the first time in a year. Game changer.

And has increased your risk of stroke and cancer.

Well, my thyroid stopped working in my 20s and I need thyroid replacement hormone for the rest of my life to function because my body doesn’t make thyroid hormone anymore. Does that raise my risk of stroke and cancer? I don’t know, maybe. But I’d rather die than live half dead. I don’t see how it’s different with progesterone and estrogen.

Having had hormone positive breast cancer and a double mastectomy, I beg to differ.

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,