How the WHI turned things on its head and we have come a long way baby!! Happy 2012

It is hard to believe that 10 years ago this July, the first reports from the WHI(Women’s Health Initiative) first hit the press and caused a major upheaval in our country in terms of how we viewed hormone treatment for women.  Headlines appeared in all of the major newspapers, soundbites aired on TV and radio shows, all echoing the same information:  based on this study(despite conflicting evidence from dozens of studies prior to this one), it was felt that hormone replacement therapy was no longer something that should routinely be prescribed to postmenopausal women due to the increased risks of breast cancer and cardiovascular complications.

The release of this information was a veritable nightmare for clinicians like myself who have worked with women for years trying to find the safest and most effective treatment options to deal with the challenges of perimenopause and beyond. Suddenly everything we had trusted was brought into question and the reaction was loud, contentious and confusing. We were advised by our various medical organizations(such as NAMS:North American Menopause Society; ACOG: American College of OB/Gyn, AMA: American Medical Society, and so on) to get women off of HRT(hormone replacement therapy) and advise them of their risks.

I have been a Nurse Practitioner since 1988 and I can honestly say, this was a pivotal moment in my evolution as a clinician. I felt as though I was between a rock and a hard place. How do I honor the “wisdom of the powers that be” yet take excellent care of the women who trusted me to provide them with accurate, up-to-date health information and help them find relief for their innumerable symptoms of hormonal imbalance? This was not an easy task but in many ways, I am thankful for the stir caused by this study as it forced many clinicians like myself to take a hard look at the information coming to us from these large scale, big Pharma-financed studies. It was time for a seismic shift for me, that’s for sure.

I have always been more holistic in my approach towards health care than what I learned in my allopathic undergraduate and graduate programs.  I had long developed a mistrust from some of the “studies” and abstracts given to me by pharmaceutical reps and this new turn of events just confirmed for me the need for ME to sort through the information myself, to resist believing the latest “headline du jour”. And I was in a perfect position to change my approach to taking care of women approaching menopause.

Thankfully one of my patients at the time told me about a special that had aired on public television highlighting “Bio-identical Hormones”, something I had heard of but honestly, didn’t know much about. I sought out a local compounding pharmacist, Alison Johnston and asked her to teach me. Not only did she mentor me and turn me on to a whole new world of compounding, but she sponsored me to go to a conference put on by PCCA(Professional Compounding Corporation of America). This is where I learned about the value of saliva testing, met the wonderful folks of ZRT lab and from that point on , I knew I had found what I was looking for: a safe, non-invasive, accurate, comprehensive way to test actual hormone levels.

My next challenge was to learn to interpret these levels and then how to prescribe BHRT in PHYSIOLOGIC doses to help alleviate symptoms of hormone imbalance and provide the many benefits of hormone treatment(see our previous blog posts on this). I had no local providers to ask….I was completely on my own and sometimes it was a scary place. But I knew there was no turning back. I had the support of my local pharmacists and the providers and staff at ZRT lab. I continued to go to any conference I could find on the topic, I read countless books and articles and soon I was treating hundreds, then thousands of women.  Not just treating them but helping them regain balance, hope and quality of life. I will soon be sharing some of their testimonials with you all in future blogposts.

So that’s the story of how I became so passionate about saliva testing and BHRT. I see thousands of women every year and I get such joy out of partnering with my patients. So many of them are like some of the people who have commented on our blog: at their wit’s end. Help is just around the corner ladies. Stay tuned and we will continue to provide you with the information and optimism that you need to get on your own road back to balance.

Oh, and by the way, patience really is a virtue. After 10 years of arguing back and forth about whether hormones are safe for women, just this week a statement was issued by NAMS and supported by 15 major medical organizations that now states that hormone replacement therapy should be offered to women.  AMEN!!! Remember, we support the use of BHRT… but this is such a sweet victory for women and those who care for them. Here is the link to the article:

NAMS statement

One last thing in closing. Today is Candace’s birthday so wishing my dear friend and colleague a wonderful celebration of life and a toast to many decades of happiness and balanced living to come!

With love,




Filed under Bioidentical Hormones, Hormone Imbalance, Hormone Replacement Therapy, Kyle Bell McAvoy, Menopause Symptoms, Women's Health & Happiness, Women's Work/Life Balance

4 responses to “How the WHI turned things on its head and we have come a long way baby!! Happy 2012

  1. Good news, although they are still not differentiating between bioidentical progeterone and synthetic progestins nor the role of testosterone which in studies does seem to show a protective effect on women taking hormone replacement. The use of Testosterone-Anastrozole implants for breast cancer survivors in treating symptoms associated with menopause also seems to be showing promise. Continuous testosterone therapy, delivered
    by subcutaneous (SC) implant, effectively treats hormone/androgen deficiency symptoms as measured by the HRQOL, Menopause Rating Scale (MRS) in both pre and post menopausal patients. Two recent studies show that women on HRT who get testosterone implants show no increased risk for breast cancer. All good news for women struggling with the symptoms of menopause and suffering rapid aging through age related decline of hormones.

    • Thanks Daniel for your insight on this. Absolutely: women who are low in testosterone(as measured by salivary levels, on my recommendation, prior to treatment) get a great many benefits from transdermal, sublingual, transvaginal and as you mentioned SC implants. Testosterone is crucial for cognitive functioning, memory, muscle and bone strength, relief of hot flashes/night sweats and libido, amongst its many functions in the body. A recent article in Oprah magazine by a breast cancer survivor(August 2012 issue: “Not for Men Only”) highlights this woman’s struggles with early menopause caused by her treatment for the cancer. Luckily she found an oncologist who was willing to listen to the advice of her gynecologist(there is hope!!) to use trandermal testosterone to treat her symptoms of exhaustion, weight gain, brain fog, low libido, aches and pains. Soon after she started to apply the cream, she became aware of a feeling of well-being, energy, improved memory and quality of life.
      It is very heartening to see that the message of hormone rebalancing is spreading. Even women who have had breast cancer can find relief so if that is you or someone you know and love, be sure to find a provider that you can work with to come up with a safe and integrative plan back to restoring health.
      Remember to check out for extensive information on breast cancer and hormone balance.
      Ciao for now

  2. Wendy

    It’s nice to see a healthcare provider so dedicated to helping people that they go above and beyond to find the answers needed to help patients. I actually just saw a giveaway on Facebook – The Wellness Project – that’s giving away one year of balance including lab tests and appointments with a BHRT physician. It’s definitely something for other people to check out and enter as (unfortunately) many people may not be able to afford this service.

    • Thanks Wendy for sharing this with us and our readers. This is not a project that I am aware of but will definitely check it out!! I do realize that in these tighter economic times it can sometimes be hard for people to afford the testing and treatment that they need and I really try to pay attention to that. In general, the cost of saliva testing and compounded medications is so much less than the model of health care that we are so accustomed to in our country and the benefits are far-reaching. I am a big believer in ordering focused testing for each of my patients as so often we ‘over order’ tests “just because”. By tailoring health care to each individual and working within a preventive health care model, we are saving money and time while improving quality of life. Amen!!

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