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Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women's Well-Being and Lengthen Their Lives -- Without Raising the Risk of Breast Cancer

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A compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health. For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flashes to m A compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health. For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flashes to memory loss; reduce the risk of heart disease, Alzheimer's, osteoporosis, and some cancers; and even extend a woman's overall life expectancy. But when a large study by the Women's Health Initiative announced results showing an uptick in breast cancer among women taking HRT, the winds shifted abruptly, and HRT, officially deemed a carcinogen, was abandoned. Now, sixteen years after HRT was left for dead, Dr. Bluming, a medical oncologist, and Dr. Tavris, a social psychologist, track its strange history and present a compelling case for its resurrection. They investigate what led the public -- and much of the medical establishment -- to accept the Women's Health Initiative's often exaggerated claims, while also providing a fuller picture of the science that supports HRT. A sobering and revelatory read, Estrogen Matters sets the record straight on this beneficial treatment and provides an empowering path to wellness for women everywhere.


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A compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health. For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flashes to m A compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health. For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flashes to memory loss; reduce the risk of heart disease, Alzheimer's, osteoporosis, and some cancers; and even extend a woman's overall life expectancy. But when a large study by the Women's Health Initiative announced results showing an uptick in breast cancer among women taking HRT, the winds shifted abruptly, and HRT, officially deemed a carcinogen, was abandoned. Now, sixteen years after HRT was left for dead, Dr. Bluming, a medical oncologist, and Dr. Tavris, a social psychologist, track its strange history and present a compelling case for its resurrection. They investigate what led the public -- and much of the medical establishment -- to accept the Women's Health Initiative's often exaggerated claims, while also providing a fuller picture of the science that supports HRT. A sobering and revelatory read, Estrogen Matters sets the record straight on this beneficial treatment and provides an empowering path to wellness for women everywhere.

30 review for Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women's Well-Being and Lengthen Their Lives -- Without Raising the Risk of Breast Cancer

  1. 5 out of 5

    Ryan Stevens

    I found this book after hearing the authors on Peter Attia's podcast. The book did a great job of continuing the conversation i heard on the show. It appears that HRT is essential to the long term health of women and I have already started conversations with the women in my life. The book lays out in detail the shortcomings of the Women's Health Initiative study and why HRT actually works for most women. This book is not just for women. Men also would benefit from learning about HRT so that they I found this book after hearing the authors on Peter Attia's podcast. The book did a great job of continuing the conversation i heard on the show. It appears that HRT is essential to the long term health of women and I have already started conversations with the women in my life. The book lays out in detail the shortcomings of the Women's Health Initiative study and why HRT actually works for most women. This book is not just for women. Men also would benefit from learning about HRT so that they can best support and understand the changes that happen in women in their lives.

  2. 5 out of 5

    Lynda

    I’d like to read some more reviews especially ones by medical professionals. The benefits of HRT presented seem to outweigh minimal risks. If the basis of this book is true, shame on the WHI doctor’s for robbing so many women of better, stronger later years.

  3. 5 out of 5

    Stephany Wilkes

    If I could, I would send a copy of this book to every woman over the age of 30, and pay her to read it. I consider it on the order of books like Good Calories, Bad Calories. As Gary Taubes thoroughly debunked decades of nutrition recommendations like carb-heavy diets and commonly held, wrong beliefs like "fat makes you fat," so Bluming and Tavris methodically examine and deflate commonly held, wrong beliefs like "Estrogen causes cancer," which it does not. This is an important book, because it i If I could, I would send a copy of this book to every woman over the age of 30, and pay her to read it. I consider it on the order of books like Good Calories, Bad Calories. As Gary Taubes thoroughly debunked decades of nutrition recommendations like carb-heavy diets and commonly held, wrong beliefs like "fat makes you fat," so Bluming and Tavris methodically examine and deflate commonly held, wrong beliefs like "Estrogen causes cancer," which it does not. This is an important book, because it is a counterpoint to commonly held, wrong beliefs that women must confront at medical appointments and even on prescription drug inserts for HRT, which still cite the 2002 WHI study that Bluming and Tavris make clear was exaggerated and misinterpreted. Indeed, the study's authors drew conclusions and made recommendations that were not supported by their own data. Before listening to a doctor or believing a prescription insert wholesale, women should do their own research and read this book. Doing so may help them feel better without believing they must increase their cancer risk in order to do so. Many women struggle with debilitating depression and anxiety, for example, and receive prescriptions for antidepressants that don't work...because their depression is caused by hormone levels, fundamentally, and antidepressants don't address those. Other women blame themselves for "giving themselves" cancer because they took HRT to stop themselves from losing their minds, and that's sad, unnecessary, and not true. For these and so many reasons, I recommend this clear and accessibly written book that makes decades of science understandable, and explains why what we think we know just ain't so.

  4. 5 out of 5

    Richard

    I recommend this book for all women over the age of 40. I read this book after hearing an interview with the authors on Dr. Peter Attia's The Drive podcast. Check that out as well, but the book is more linear in its presentation of the information. I recommend this book for all women over the age of 40. I read this book after hearing an interview with the authors on Dr. Peter Attia's The Drive podcast. Check that out as well, but the book is more linear in its presentation of the information.

  5. 4 out of 5

    Yycdaisy

    This is an important book for women with menopausal symptoms. Takeaways are that the WHI overstated the dangers of HRT, there can be serious health consequences for women who do not use HRT, and that women could continue to take estrogen longer than the standard 10 years. Less important but good to know was the information that none of the over-the-counter solutions for menopausal symptoms do anything. It was also quite interesting to read about all the medical world arguments over this subject, This is an important book for women with menopausal symptoms. Takeaways are that the WHI overstated the dangers of HRT, there can be serious health consequences for women who do not use HRT, and that women could continue to take estrogen longer than the standard 10 years. Less important but good to know was the information that none of the over-the-counter solutions for menopausal symptoms do anything. It was also quite interesting to read about all the medical world arguments over this subject, although there is more information here than some readers would require. I was not going to read the chapter called "Can Breast Cancer Survivors Take Estrogen?" because what's the point if one does not have cancer? It's actually a fascinating story of the author's efforts to study this and how he was hindered by FDA. In the end, his and other's research in this area showed that HRT does not contribute to cancer in those women. Personally, the book set my mind at rest about HRT as the benefits seem to outweigh the possible harm.

  6. 4 out of 5

    Lisa Hunt

    This was an interesting book - pretty much the first book I've read on the subject matter, so I have a LOT to learn. The information was presented in a straight forward, factual way, but also very readable to a non-science person like me. I also appreciated finding the hidden bits of humor along the way! It definitely gives lots of info on both sides of the debate and it thoroughly researched. I do wish there was just a definitive answer, but that is probably too much to hope for. They do lay ou This was an interesting book - pretty much the first book I've read on the subject matter, so I have a LOT to learn. The information was presented in a straight forward, factual way, but also very readable to a non-science person like me. I also appreciated finding the hidden bits of humor along the way! It definitely gives lots of info on both sides of the debate and it thoroughly researched. I do wish there was just a definitive answer, but that is probably too much to hope for. They do lay out their argument in a very convincing manner and they also present the opposite viewpoint as well.

  7. 5 out of 5

    Sebastian

    This is a competent review of the benefits and risks of hormone replacement therapy (should we just call it hormone therapy?). The authors' conclusion is that the benefits (menopause symptoms like hot flashes and depression; cardiovascular disease risk; Alzhiemer's disease risk) far outweigh the risks (purportedly, breast cancer risk). The CVD and Alzheimer's piece only works for women who start therapy within 10 years of menopause and stay on HRT. Little utility if you start e.g. in your 60s or This is a competent review of the benefits and risks of hormone replacement therapy (should we just call it hormone therapy?). The authors' conclusion is that the benefits (menopause symptoms like hot flashes and depression; cardiovascular disease risk; Alzhiemer's disease risk) far outweigh the risks (purportedly, breast cancer risk). The CVD and Alzheimer's piece only works for women who start therapy within 10 years of menopause and stay on HRT. Little utility if you start e.g. in your 60s or if you drop off afterwards. [Note: John Ioannidis at Stanford apparently doesn't agree with this conclusion, so take it with a grain of salt. I haven't read any of this literature myself and am taking things on faith.] The book is interesting when considered in the context of many medical professionals who aren't comfortable prescribing HRT, largely in the wake of a 2002 publication from the Women's Health Initiative that indicated a (statistically insignificant) higher risk of breast cancer in an HRT cohort versus a control group. To this day one botched study has cost American women probably hundreds of thousands or millions or more of quality-adjusted life years. The number keeps on going up because misconceptions still haven't been corrected. I dare you to ask your favorite doctor over age 50 what they think of HRT. This highlights a theme I've been thinking a bit about, the danger of first principles thinking in medicine: Medical education in the United States is horrifyingly bad in many ways. But one of the most insidious things is the way you are encouraged to think about interventions and their molecular mechanisms. Tamoxifen is an estrogen receptor antagonist and we use it to treat cancer. So more estrogen must be cancer-promoting, right? Integral of serum estrogen == disease risk right? This is as wrong as our thinking on statins (we thought they inhibit cholesterol synthesis, which they do, but most of the therapeutic effect comes from upregulating LDL receptor expression). We don't know all the variables we are playing with in biology. Biology is messy. We generally don't know what binds to what in what cells in vivo, with what precise downstream results. There's one type of trustworthy evidence* and that's a randomized, controlled, double-blind study measuring the outcome of interest and not some surrogate marker. Period. Everything else might be informative but can also be extremely misleading. *Observational studies with massive effect sizes that are concordant across studied populations like lung cancer and smoking, or chimney sweeps and scrotal cancer are also acceptable. I would have liked more reflection on how the WHI got so messed up and what led the authors to publish what they did. Another good example leading me to think scientific institutions need a good hard look and some form of renewal.

  8. 4 out of 5

    Eileen Margaret

    I wish this book had been available ten years ago so I could have advised my mother and other beloved women in my life to not fear hormone replacement therapy. This is an important deconstruction of how medicine gets dispersed through bad science and popular media. The messsge is presented clearly and makes the issue understandable. Highly recommend for anyone approaching menopause or cares about other women in that position. Everyone can learn something.

  9. 5 out of 5

    Ekaterina Miroshnichenko

    Started to educate myself on the women’s health matters and had lots of cross references to this book, was shocked by the data which authors presented. A must read to anyone who has loved ones coming close to menopause or is experiencing it herself.

  10. 5 out of 5

    Patricia Burgess

    The authors, oncologist and psychologist, tackle the Women’s Health Initiative which in 2002 advised that HRT and ERT were detrimental to women, a factor in increased breast cancer, heart disease, blood clots. In fact, the study was flawed and the results highly distorted. Estrogen is critical to women’s health, maybe even more after menopause, with studies finding its efficacy in helping prevent osteoporosis, protection against dementia, important for brain health, not increased risk of breast The authors, oncologist and psychologist, tackle the Women’s Health Initiative which in 2002 advised that HRT and ERT were detrimental to women, a factor in increased breast cancer, heart disease, blood clots. In fact, the study was flawed and the results highly distorted. Estrogen is critical to women’s health, maybe even more after menopause, with studies finding its efficacy in helping prevent osteoporosis, protection against dementia, important for brain health, not increased risk of breast cancer, blood clots (if taken in non-pill form) or heart disease. A huge disservice to many women trying to manage menopause, the doctors recommend optimal time to begin and continue use of HRT. Well-documented, reasoned conclusions.)

  11. 5 out of 5

    Jess Dollar

    Very helpful information as I begin to research his topic for myself as a 45 year old. Heard the authors on Peter Attia’s podcast. I’m not sure I’ve made up my mind about bioidenticals versus traditional prescription HRT meds but I am sure some kind of hormone therapy is in my future.

  12. 5 out of 5

    Jo Wessell

    Excellent factual book about HRT for women. A must recommendation for both clinicians and the general public. This book empowers clinicians to be able to have those discussions about the clinical evidence about HRT benefits and risks. It informs the reader to understand how research can be flawed due to being blinded by the hypothesis and making stats fit the researchers belief. I would recommended both males and females read this book to enable to support loved ones through difficult decisions Excellent factual book about HRT for women. A must recommendation for both clinicians and the general public. This book empowers clinicians to be able to have those discussions about the clinical evidence about HRT benefits and risks. It informs the reader to understand how research can be flawed due to being blinded by the hypothesis and making stats fit the researchers belief. I would recommended both males and females read this book to enable to support loved ones through difficult decisions about women’s health and management! Decisions that can shorten or lengthen a woman’s life. These decisions can improve or worsens the quality of a woman’s life! Make the right well informed choice which is personalised to you or them!

  13. 4 out of 5

    Rachelle

    This is way more information than I anticipated. I appreciate the thoroughness, and not only considering the physical aspects, but the mental taxation of making individual health decisions.

  14. 5 out of 5

    Sue

    A good, well written and understandable look at the fear and misinformation surrounding menopause and oestrogen replacement. The author is a expert oncologist with a lifetime of experience. He lifts the lid on how clinical trials are run and manipulated. He shows us the links to corporate connections that form bias and mislead people. Probably the best book I've read about HRT and in particular, the vital importance of oestrogen to the body. A good, well written and understandable look at the fear and misinformation surrounding menopause and oestrogen replacement. The author is a expert oncologist with a lifetime of experience. He lifts the lid on how clinical trials are run and manipulated. He shows us the links to corporate connections that form bias and mislead people. Probably the best book I've read about HRT and in particular, the vital importance of oestrogen to the body.

  15. 5 out of 5

    Joanne

    Excellent summary of why the scare about HRT and breast cancer is unfounded. Women should know that HRT at the time of menopause can be life changing. Not only will it provide relief from menopausal symptoms, but can increase life span and protect against dementia, heart disease and osteoporosis.

  16. 5 out of 5

    Mohammad Ashori

    It didn't take me long to finish this book but it is pithy because there is a lot of different details about various studies which have been done over the years regarding hormone replacement therapy for women. I really appreciate it the fact that the author didn't really have a big steak in the argument because oftentimes whenever I read books or articles or journals or research literature it is often by an author who is sponsored by a pharmaceutical company or has some sort of personal gain fro It didn't take me long to finish this book but it is pithy because there is a lot of different details about various studies which have been done over the years regarding hormone replacement therapy for women. I really appreciate it the fact that the author didn't really have a big steak in the argument because oftentimes whenever I read books or articles or journals or research literature it is often by an author who is sponsored by a pharmaceutical company or has some sort of personal gain from the outcome of the discussion. If I were to dissect the book down of course there are some clinical mistakes that the author made, I think if enough physicians read any book on this topic there's always something you can find. But overall the message is incredibly important. It teaches you as a physician to understand that just because a research study is done and the authors come to a certain conclusion it doesn't mean that that is the right conclusion or that the statistical analysis that was done was accurate. In this particular case the book really goes into detail and explains what estrogen and progesterone does in the body and for which patients this kind of treatment is appropriate. In some ways the book does seem like it is praising hormone replacement therapy or hormone therapy excessively and I think if you can take that with a grain of salt and understand that this author how to overcome the overall bias against these medications it's still is an incredibly important message that is written. Moving forward, same as before, I will inform my patients on the risks and benefits of estrogen replacement therapy or hormone replacement therapy. It will always be a decision that we will make together but in the end, the patient is the one who is responsible for their decisions. To me, this is patient empowerment. Other things I learned in this book were the subtle signs of menopause which of course many physicians overlook myself included. If I was a woman and actually had gone through menopause I suspect that I would have a lot more details to fill in that knowledge gap. But unfortunately, Western medicine remains a very male-dominated field. Many of our research studies in various subspecialties still don't include women. And so it can be really difficult for a male doctor to get a proper perspective on the cases of menopause. The book has a small section on Bioidentical hormones. I am not sure what to think of that, I have done some research on the topic and perhaps there is some use for them. But I think the author does a great job of making the distinction that if a patient needs hormone replacement therapy then just provide them with home and replacement therapy and since the medications which are available right now are fairly safe according to her argument then the discussion for bioidentical hormones is unnecessary. There is a time and place for bioidentical hormones and I'm still trying to figure that out but I wouldn't agree with the author that they are completely useless or unnecessary or unsafe.

  17. 5 out of 5

    Kathleen

    Every woman (and their doctors) should read this book. It debunks the myth that estrogen causes breast cancer, an incorrectly interpreted finding of the big Women's Health initiative that was abruptly cancelled after two of the members of the reviewing committee published their own biased opinions before any of the other committee members had read it or had a chance to weigh in. Estrogen therapy not only does not cause breast cancer, it is preventative against it, as it is protective against dem Every woman (and their doctors) should read this book. It debunks the myth that estrogen causes breast cancer, an incorrectly interpreted finding of the big Women's Health initiative that was abruptly cancelled after two of the members of the reviewing committee published their own biased opinions before any of the other committee members had read it or had a chance to weigh in. Estrogen therapy not only does not cause breast cancer, it is preventative against it, as it is protective against dementia, colon cancer and many other common medical risks for woman in middle to old age. Written by a practicing oncologist and clinical psychologist, it is meticulously researched and documented and presented in text very accessible to the general lay reader.

  18. 5 out of 5

    Johanne

    Detailed analysis mostly countering the narrative of the Women's Health Initiative (WHI) study claiming Hormone Replacement Therapy (HRT) increased the risk of getting breast cancer. I was particularly interested in the views of Bluming, an oncologist. I appreciated having so many referenced studies I could read at a later date. I would've liked to have some information on the effects of estrogen on mood, but could not find any. Maybe in a further edition. I think it's a very important component Detailed analysis mostly countering the narrative of the Women's Health Initiative (WHI) study claiming Hormone Replacement Therapy (HRT) increased the risk of getting breast cancer. I was particularly interested in the views of Bluming, an oncologist. I appreciated having so many referenced studies I could read at a later date. I would've liked to have some information on the effects of estrogen on mood, but could not find any. Maybe in a further edition. I think it's a very important component to look at, especially since many doctors still offer antidepressants as a first line of defence against difficult perimenopausal symptoms instead of HRT.

  19. 4 out of 5

    Christina

    This is a very important and informative book! I read it after hearing the authors speak onPeter Attia’s ‘The Drive’ podcast. I wish all women knew about the information in this book; the health care system is doing women a disservice by not offering current HRT information, that is free of the scary data-mined statistics compiled in the 2002 WHI. I took a star away not because the book was lacking in any way, but because the information was dry and presented in a manner that was a bit inaccessi This is a very important and informative book! I read it after hearing the authors speak onPeter Attia’s ‘The Drive’ podcast. I wish all women knew about the information in this book; the health care system is doing women a disservice by not offering current HRT information, that is free of the scary data-mined statistics compiled in the 2002 WHI. I took a star away not because the book was lacking in any way, but because the information was dry and presented in a manner that was a bit inaccessible to the layperson reader. (I fell asleep easily when reading it before bed!)

  20. 4 out of 5

    Farzana Friars

    Every woman should read this - especially those prior to the onset of menopause. Being proactive rather than reactive is obviously way more beneficial. If I had read this in my early forties, I would be my happier self, still be married, and more steady in my career! I attributed majority of my symptoms to the natural aging process and bad genes. Do not make that mistake - regardless of whether you take HRT or not. It is not natural...

  21. 4 out of 5

    Ladonda

    This book was recommended to me by my OB/GYN. It was super informative with lots of science and facts but still very easy to read. I did get bogged down from time to time because there were so many studies and facts presented but overall it was a very helpful tool as I did personal research to determine whether or not HRT is something I should pursue for myself. I highly recommend it for anyone who is at that cross roads.

  22. 4 out of 5

    Patty Pacelli

    The book makes a good argument and disputes a common thinking, which I have heard from my MD. It was recommended by my naturopath. It convinced me to go back to taking hormones, but the book is fairly repetitive and a lot of the studies and statistics get boring for a non-medical professional. It needs to be in there though, to prove the points, which it does.

  23. 5 out of 5

    Paula Barker

    Another excellent book for women wanting to be empowered over their health. Research and data upon research, this compilation of the history of the largest women’s health study sheds light on why women fear breast cancer related to estrogen. It happens to all of us women, menopause, There is nothing to fear. This book educates us on data that our doctors never will. A must read.

  24. 4 out of 5

    Emma Campbell

    Not an easy read as lots of study quotations to follow but definitely worth a read if interested in women’s health and want to understand more about the women’s health initiative. Certainly aided my understanding but won’t change my practice.

  25. 5 out of 5

    Terri Trujillo dunlap

    The question of choosing HRT or not can be so difficult. And now I understand why...we have been given a lot of mixed messages regarding their safety. This book does a great job explaining why that happened and why they are both safe and beneficial.

  26. 4 out of 5

    Tina

    This book may be an illustration of how you can find a study to prove anything or a lot of people are terribly wrong. Be sure that you do your own research and ask your doctor about important matters concerning your health.

  27. 5 out of 5

    Alison Spinney

    Most enlightening and infuriating that I, along with millions of other women, were duped into stopping our HRT back in 2002-3, as a result of that bogus WHI study!!! now... I'm too old and way too many years past menopause to reap the benefits -- brains/bones/heart/SLEEP! -- of HRT. Most enlightening and infuriating that I, along with millions of other women, were duped into stopping our HRT back in 2002-3, as a result of that bogus WHI study!!! now... I'm too old and way too many years past menopause to reap the benefits -- brains/bones/heart/SLEEP! -- of HRT.

  28. 4 out of 5

    Lisa

    A little deep but very informative. I get the scary feeling that results can be interpreted in multiple ways to indicate the results the researcher wants to come out.

  29. 5 out of 5

    Meggins Scheel

    Excellent treatment of the subject.

  30. 4 out of 5

    Timc

    An excellent analysis of the importance of this hormone and the impacts of faulty studies conducted in the early 2000s. I believe it is an excellent read for women of all ages.

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