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Community Commentary: Women, don't be afraid to take hormones

Birth control hormones (BCH) and menopausal hormone therapy (MHT) are on my artist's palette as a psychosexual gynecologist. Their judicious use, mostly out of regular pharmacies, safely improves the quality and length of life of females from puberty to the grave. Additionally, their intimate partners, family, friends and coworkers benefit when health, mood and relations are enhanced.

I know the phobias. First, there is the erroneous notion that use of hormones makes women gain weight. Not so. There is an epidemic of overweight people in the U.S, affecting 35% of children and 65% of adults.

Only a minority of women who are candidates for MHT are taking it. Therefore, MHT is not the central culprit in our expanding menopausal waistlines. We are too immobile, and consume too many calories as a society.

Medical research has shown no significant change in weight when women take hormones. In fact, we can reduce premenstrual syndrome (PMS)-associated food cravings with sophisticated use of BCH. This prevents the grazing that causes some females to nosh their way up five pounds every cycle.

BCH are recommended as safe by multiple eminent experts in obstetrics and gynecology (Ob-Gyn) for nonsmoking women who are not at risk for carrying a blood clotting gene until age 54. The American College of Ob-Gyn published a practice bulletin recently on the numerous noncontraceptive benefits of BCH.

During my 25 years of practice, I promise you I have observed all of these outcomes many times over, and have even helped some women avoid a hysterectomy. Here's the list: less menstrual bleeding and pain, more regular and predictable periods, safe long-cycling (i.e. periods every three months), fewer PMS symptoms (both physical and psychological), a 50% reduction in the lifetime risk of ovarian cancer with just four years of use, decreased cancer of the lining of the uterus, a marked improvement in acne and unwanted facial hair, preservation of bone density and masking of menopausal transition symptoms, which often last for many years.

All that with no increase in body weight, and effective contraception to boot! Menopausal women all tend to gain weight. One study showed that women not taking MHT gained twice as much (eight pounds) as women who took MHT (four pounds). Of course, it depends on the type and dose of MHT.

This brings me to the second phobia. You know: breast cancer. Data spanning the 50 years since the inception of BCH has repeatedly shown no association with breast cancer. Much of that research was done when pill doses were markedly higher than today.

The big Women's HealthInitiative, a poorly designed government study that put all MHT on its ear in 2002 found that the estrogen–only treatment group had no increase in breast cancer.

Suffice it to say, while we need more well-done research, females and their providers making decisions today have many reasons to confidently use hormones throughout life.

As explained by Dr. Philip DiSaia, recent past chairman of both the American Board of Ob-Gyn and Gynecological Oncology at UCI Medical Center, BCH significantly reduce the national incidence of ovarian cancer.

This is an uncommon but deadly disease for which there is no successful screening. He concludes from medical evidence, and his venerable career, that there is no increase in breast cancer with MHT, and that the benefits outweigh the risks.

So, give this some thought. Question your health practitioners on the benefits and risks of birth control or menopausal hormones.

Adolescent girls and women, if you choose not to avail yourselves of these potentially health-enhancing and life-extending compounds, at least you can't use the fear of weight gain or breast cancer as excuses anymore.

JANE BENING is a board-certified gynecologist in private practice in Newport Beach.

Copyright © 2014, The Baltimore Sun
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