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The Myth and Reality of Hormone Replacement Therapy

by Mark T. Simpson, M.D.


All hormones aren’t created equal—and they don’t act equally either. Misunderstanding of this basic principle has led many people, women and men, to unnecessarily fear the risks and fail to experience the numerous benefits of hormone replacement therapy (HRT).

Much of the controversy regarding HRT for women arose following the Women’s Health Initiative study, published in 2002. While its widely reported finding of increased incidence of beast cancer and cardiovascular events was significant, important details were rarely discussed. All the negative effects reported were due to use of a synthetic (non-human) progestin; women who received estrogen alone had only benefits. Studies that used bioidentical (human) progesterone have shown a very small rate of negative effects, and many positives.

Subsequent research has been even more supportive of HRT. A 2013 Yale review of 27 studies showed a 27 percent reduction in mortality and a profound improvement in quality of life for women using HRT. A 2015 review of 43 studies involving 52,000 women showed no increase in cancer, heart disease or mortality with HRT.

On the other hand, HRT has been shown to have multiple benefits for women, including increased libido, lubrication, energy level, muscle mass and bone density. Improved memory, concentration and mood, with fewer mood swings, are also common benefits, as are decreased hot flashes and night sweats. Men can expect similar results from testosterone replacement. Concerns about increased risk of prostate cancer have been disproven.

The only people who should forego HRT are those with a personal history of hormone-sensitive cancer, such as breast, uterine, ovarian or prostate. A family history of such cancers rarely prohibits hormone replacement.

For optimal results, HRT requires a thorough evaluation by a clinician who is highly trained and experienced, as well as the tailoring of hormone dosages to each individual, using bioidenticals whenever possible. While the level of benefit is variable, many people will receive numerous benefits with minimal risk.


Dr. Mark Simpson practices family medicine at the Wellness Clinic, located at 4513 Hixson Pike Ste. 102, Hixson. For more information, contact the clinic at 423-877-7999 or

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