How views on hormone therapy have changed over the decades – a scientific overview

Dear MHI reader,

Hormone therapy (HRT) for menopause has experienced a remarkable transformation over the past century. 

From its early days as a revolutionary treatment to periods of scepticism and renewed acceptance, the journey of HRT reflects the evolving understanding of women’s health. 

Here’s a concise overview of how perspectives on hormone therapy have shifted over the decades.

The Early Days: Discovery and Enthusiasm

In the 1940s, Premarin, derived from the urine of pregnant mares, became the first widely used hormone therapy for menopausal symptoms. Its popularity soared in the 1960s, especially after Dr. Robert A. Wilson’s book “Feminine Forever” portrayed menopause as a hormone deficiency disease that could be «cured» with oestrogen.

This perspective led to a significant increase in HRT prescriptions. 

Emerging Concerns: Risks and Re-evaluations

By the 1970s, studies began to reveal that oestrogen-only therapy increased the risk of endometrial cancer. This led to the practice of combining oestrogen with progestogen to mitigate such risks.

In the 1980s and 1990s, HRT was also promoted for preventing chronic conditions like osteoporosis and heart disease.

However, the early 2000s brought significant scrutiny. The Women’s Health Initiative (WHI) study in 2002 linked HRT to increased risks of breast cancer, heart disease, and stroke, leading to a dramatic decline in its use.

Subsequent analyses highlighted that the average age of WHI participants was 63, suggesting that initiating HRT closer to menopause onset might present a different risk profile.

Modern Perspectives: Personalised and Informed Choices

Today, HRT is recognised as the most effective treatment for alleviating menopausal symptoms such as hot flushes, night sweats, and vaginal dryness.

Bioidentical hormones, which are chemically identical to those the body produces, have gained popularity.

Healthcare providers now advocate for shared decision-making, ensuring women are informed about the benefits and risks of HRT. This approach empowers women to make choices aligned with their health goals and personal preferences.

Stay Updated, Knowledge is power.

The narrative of hormone therapy in menopause underscores the importance of ongoing research and individualised care. As our understanding deepens, women are better equipped to navigate menopause with informed choices that enhance their quality of life. 

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