Hormone Replacement Therapy and Stroke Risk: Myths and Facts

Hormone Replacement Myths and Facts

Hormone Replacement Myths and FactsYou may be considering bioidentical hormone replacement therapy (BHRT) to benefit your health. But one of your main concerns may be the risk of stroke. Stroke is the third-leading cause of death for women in the U.S., and of course you want what’s best for your health.

If you’re confused, you’re not alone. There is a great deal of misinformation surrounding BHRT and the risk of stroke. You can start to separate fact from fiction by gathering updated information, and by speaking with a doctor who keeps up with the latest medical findings about BHRT.

Here you can find out the truth behind some common myths around BHRT.

Myth: BHRT increases the risk of stroke.

Fact: BHRT does not necessarily increase your risk of having a stroke.

There is a great difference in risk factors for stroke, depending on whether synthetic or bioidentical hormones are used in treatment. Also, how the hormones are taken (in pill form, or a patch or gel on the skin) yields different results. A long-running study of more than 100,000 women in France (called the E3N study) found that bioidentical estrogen hormone patches and gels were linked with lower stroke risk than estrogen pills. Women taking estrogen through low-dose patches with pill-form progesterone slightly lowered their risk of stroke compared to women not using hormone replacement therapy.

Research published in the Journal Maturitas studied a group of 16,906 Swedish women ages 45 to 73 over a period of 10.5 years. They found that the risk of stroke was no different for women undergoing hormone replacement treatments than for those who did not. Excess body weight, smoking, older age, and high blood pressure were all found to be factors that increased the risk of stroke. Women who started treatments before menopause had a lower risk of stroke compared to those who started treatment after menopause.


Myth: The Food and Drug Administration (FDA) has not approved Bioidentical Hormone medications.

Fact: The FDA has listed drugs approved for menopausal hormone therapy; many are bioidentical hormone medications.

Some bioidentical hormone products are approved and regulated by the FDA, and some that are not. All hormones used for hormone balancing are man-made. Confusion arises between compounds that are custom made by pharmacies, and those that the FDA has approved.  Many bio-identical hormone medications are commonly compounded by pharmacies according to a doctor’s prescription.

Compounding pharmacies are able to provide customized medications, including BHRT according to a doctor’s recommendations. They can prepare ointments, creams, and gels and other forms. They are not subject to FDA regulations.

The FDA has approved bioidentical hormone products including pill, gel, spray, and patch preparations.  A 2013 study mentioned by the Cedars-Sinai Medical Center shows that certain FDA-approved products (rather than compounded ones) may be tied to a slightly lower risk compared to synthetic hormones in pill form. Researchers stress that further confirming studies are needed.

Myth: Only one kind of Bioidentical Hormone Replacement Therapy is safest.

Fact: There is no one-size-fits-all treatment for hormone balance. Your treatment plan requires careful decisions that you and your doctor should make.

Like any treatment, hormone balancing presents benefits and possible unwanted side effects and risks. Each person has different risk factors for stroke and other threats to health. Hormone treatment is one of many factors that impact your long-term health. Changes to improve your nutrition, response to stress, and lifestyle routines make a big difference in lowering your risk of disease.

Whether or not to seek BHRT and which treatment plan to follow are decisions you’ll want to make with a doctor who has up-to-date information. 

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Next Step: Take Action

Dr. Betty Keller offers hormone rebalancing in Franklin Lakes, NJ at the Optimal Wellness Center.  Call us at 201-485-7930 to learn more about her approach to wellness and hormone replacement therapy for your optimal health.  You can also subscribe to her free health tips to help you look and feel your best.