Ovaries vs. HRT:
The Crucial Differences

For many, many women life after menopause is more than they can bear, so they turn to their doctors for help. And for over eighty years their doctors have been prescribing hormone replacement therapy, or HRT, which is usually administered in a pill made of estrogens derived from horse urine and a synthetic progestin, a progesterone derivative. Most women and doctors believe that HRT replaces the ovarian hormones lost during menopause and therefore expect women’s health and well-being to improve substantially with standard HRT. However, recent studies like the Women’s Health Initiative (WHI) have proven that HRT is not healthy for women. Specifically, HRT was found to increase rates of heart disease and breast cancer, both of which are quite low for women before menopause. What went wrong? If HRT replaces the very same hormones the ovaries used to make, how can it be so unhealthy?

The answer is simple. HRT does not replace the hormones of the ovaries. In fact it was never designed to do so.

On the surface it certainly seems reasonable to “replace” lost estrogen with another readily available estrogen (from the urine of pregnant mares) and lost progesterone with a progesterone-like hormone. The common assumption is that estrogen is estrogen, right? Wrong. The leading HRT drug, Premarin™, which is an acronym for Pregnant Mare Urine, replaces almost none of the human estrogens and includes very high levels of horse estrogens, none of which are natural to women and can accumulate to very high levels. Additionally, taking horse estrogens, or any estrogen in pill form, begins a cascade of events that results in substantially lowering levels of testosterone, an important hormone for women as well as men.

Ultimately, taking Premarin™ creates a very unnatural balance of hormones which barely resembles functional ovaries, which begs the question, “Why call it hormone replacement therapy?” The Women’s Health Initiative taught us that instead of stopping heart disease, preventing breast cancer, and preserving sexual response, Premarin™ increases heart disease, breast cancer and does nothing to restores sexual function. The only reason that this mix of hormones is called HRT is because the FDA, Food and Drug Administration, allows pharmaceutical companies to use this term. In my opinion, HRT was chosen because it sounds better than it really is.

The doctors who developed HRT undoubtedly thought they were helping women, and HRT has enough estrogen in it to be helpful in small ways, but it doesn’t give women what they are looking for, which is a real replacement for what their ovaries gave them for thirty-five or so years. Ovaries are not simple organs and to think that their function can be replaced with a single pill is extremely shortsighted.

Any well-informed doctor will tell you, ovaries are more than just a chemistry set for reproduction. Ovaries provide a host of hormones, all divvied up and parlayed in very precise, balanced portions, to help every organ system in a woman’s body work together like a well-tuned orchestra. Giving a woman Premarin™ is like giving a malnourished person only chocolate to eat. The immediate needs are met, but chocolate is not going to keep a person healthy or feeling good for long.

To truly replace the function of the ovaries would require time, patience, appropriate products and a common goal between a woman and her doctor. To attempt true ovarian hormone replacement requires skills and knowledge from the doctor and good feedback from the woman, as women have different levels of comfort all within the window of normal hormone levels. With the hormone products that are available now, only a fraction of what is lost as ovaries fail can truly be replaced. It is time to be truthful with ourselves and our doctors. Only with truth can progress and more appropriate products be identified and then manufactured.

The truth is, menopause is a female form of castration, cutting us off from sexual pleasures and an overall sense of well being, as well as putting our physical health at risk. Every woman has the right to reject this castration if she so chooses. Now that you know that HRT is nothing more than a band-aid, you can go to your doctor and say you don’t want it; you want real ovarian hormone replacement. A doctor who knows and understands ovarian function and who has the same important goal as you, which is to truly replicate ovarian hormone balance, can make a meaningful difference. He or she can advocate for women and urge the pharmaceutical companies to develop the products that we need. If your doctor doesn’t share your goal, then you will have to find another doctor who does. They are out there.

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