Experts Take Differing Views on Safety, Necessity of HRT

When Dr. Michael Simmons was only 38 years old he had his first stroke -- a year later he had his second one. At the time, Simmons was working as an obstetrician with a busy work schedule. He knew he was under a lot of stress, but doctors couldn't reach a diagnosis. It turned out that Simmons was suffering from hormone deficiency. "Traditional medicine couldn't find answers," Simmons said. "It took a doctor who thought outside the box to find out what was wrong with me." Since his strokes, Simmons has hung up his hat as an obstetrician and has taken on a new role, working in hormone replacement therapy (HRT). His practice in Frontenac, Kan., Simmons Medical Clinic, specializes in HRT. "I just love what I do," Simmons said. "A lot of people I work with, their lives are completely changed." Controversial Topic HRT replaces hormones in the body, such as testosterone, estrogen and progesterone, that are lost. Occurrences such as menopause, thyroid dysfunction, removal of prostate and hysterectomies can all require hormone replacement. But HRT is a controversial topic. "There has always been those that are for it and those that are against it," said Mary Ann DeVoe, a nurse practitioner at Freeman Southwest Women's Center.
DeVoe says HRT is more personalized than it used to be. "Now we look at individuals," she said. "Their benefits and their risks." One of the controversies surrounding HRT is bio-identical hormones versus synthetic hormones. DeVoe describes bio-identical hormones as having the same chemical structure as hormones the body already produces. "Bio means life," DeVoe said. "Bio-identical therefore means 'life identical' or 'the same as life produces.'" Synthetic hormones have a different chemical structure than those produced by the body. Simmons describes synthetic hormones as "foreign." Both ingredients in bio-identical and synthetic hormones come from natural sources. Many believe bio-identical hormones are safer than synthetic. But DeVoe says there's no evidence to support this. "A lot of people hear bio and they think it must be safe," she said. "There's nothing to say that they're any safer." But Simmons only uses bio-identical hormones at his clinic. He's a strong supporter of bio-identical hormones over synthetic. "All bio-identical drugs are much safer," he said. "We're giving our patients a substance that their body already recognizes as opposed to something foreign it has to figure out to use." The Women's Health Initiative, a 15-year research program started in the early '90s addressing the most common causes of death, disability and poor quality of life in post-menopausal women, alarmed many people about HRT.

The study found that estrogen plus progesterone HRT resulted in increased risk of heart attack, increased risk of stroke, increased risk of blood clots and increased risk of breast cancer.

"It had some good information but it also scared a lot of people that probably would have benefited form using HRT," DeVoe said.

Alternatives

There are alternatives to using HRT. DeVoe says the "real natural approach" is to substitute HRT with exercise and diet modifications.

Ann Sutton, owner of Natural Health Center in Webb City, is doing just that. She, like Simmons, knows first-hand what it's like to suffer from hormone deficiency. After trying HRT, she opted for a more "natural" approach.

"I couldn't take HRT," she said. "The side effects were terrible, nausea, leg pain, headaches. I started this business 19 years ago, right after I found out these natural products worked for me."

Natural Health Center offers natural supplements derived from plants and herbs. But Sutton is quick to say her products are not actual treatments for hormone deficiency.

"We can't cure, diagnose or treat," she said. "What we do is nourish the body and help it heal itself, maintaining a balance in hormones."

Sutton is not oppose to HRT and says, "It just wasn't for me." She admits natural supplements may not work for everybody. "That's why we need both options," she said. "Individuals need a choice. If I didn't have that choice, I don't know what I would have done." Signs of Hormone Deficiency Some common signs you may be suffering from hormone deficiency are: Hair lossAbdominal weight gainEarly morning and late-night fatigueChanges in thickness and smoothness of fingernailsMemory lossAnxietyDepression
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