An Important Update on Current HRT practices from Dr. Regula Burki

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From Winnifred Cutler, Ph.D.
“Dr. Regula Burki summarizes results of the International Menopause Society (IMS) meetings held in Rome, June 2011.

Dr. Burki concludes the current guidelines put forth confirmed her own long-standing practices and recommendations for women.

These new international standards are consistent with what I have reported in my latest book: Hormones and Your Health." (click for details)

Dear Winnifred,
I attended the International Menopause meetings last week in Rome. There were numerous component societies, among others the Hormone institute and NAMS (North American Menopause Society) from the United States. Various international menopause societies were represented, each holding their separate sessions.

Symposia were held as plenaries and by big pharma, etc. I spent most of my time on the sessions on the brain and on progesterone and went to hear the current HRT guidelines by the various entities.

The gist for practice is that I stand reconfirmed in what I have been doing for years:

Most of the risks found in the WHI (Women’s Health Initiative) are irrelevant to women under 60
Looking at RCTs (Randomized Controlled Trials) on young symptomatic women, the observational pre WHI studies are confirmed demonstrating a benefit from HRT

*In 2002 the alarmist media message generated from released WHI results scared women of all ages off HRT, later careful analysis concluded that preliminary data caused clinicians and consumers to make poor decisions on inaccurate, biased sound-bites.
Progesterone or Dydrogesterone are the best progestins to use.
MPA is "poison" (the synthetic progestin, medroxyprogesterone acetate)
Transdermal (as delivery route) is best and has the lowest, or possibly no VTE (venous thrombo-embolic event) risk
Cyclic regimen may be better for the brain and the breast
If someone is doing well on HRT even after 60, you might consider decreasing the E2 dose, but there is no compelling reason to stop HRT, or MHT as some now like to say.

I look forward to speaking with you soon!

Regula E. Burki, M.D., FACOG. - Bern Switzerland: past president of the Utah section of the American College of Obstetricians and Gynecologists and Utah Women Physicians section of the Utah Medical Association. Helped edit Hormones and Your Health.