Many doctors are afraid to treat hypogonadism, particularly in women, with hormonal treatment. Primarily, this is because of the Women's Health Initiative (WHI). The WHI advertised that it used HRT for profound hypogonadism even though it didn't. Then, when the WHI showed that the study drugs made women sicker it looked like HRT was bad for a women's health.
HRT, hormone replacement therapy, is one of the most successful areas of medicine. The failure of the WHI is not the failure of HRT rather it the failure of non-HRT. The study drug that was used, Premarin™, does not replace any hormones at all which makes it non-HRT. Drug studies prove it. Treatment for profound hypogonadism would be just as healthy if it were done right with pure, measured and monitored hormone replacement.
You can use the letter below to help your doctor understand that you want eugonadal hormone replacement to treat your hypogonadism to improve your health, your well-being, and your quality of life.
I am interested in safe and healthy treatment for my hypogonadism with eugonadal hormone replacement not what was used in the Women's Health Initiative (WHI). The results of the Women's Health Initiative and its study drug, Premarin™, are not relevant to the treatment of profound hypogonadism because no replacement of hormone was done. Premarin™ reduces testosterone and progesterone levels to severely low profound hypogonadism levels and raises estrogen to significantly higher than normal levels. Everyone can agree that Premarin™ creates abnormal hormone levels never seen before or after ovarian failure.
Hypogonadism (also called peri-menopause) begins when 1 or 2 gonadal hormones fall below normal levels. Profound hypogonadism (also called menopause) begins when 3 or more gonadal hormones are below normal levels.
The gonads of men and women are controlled by the same gonadotropins, FSH and LH, and produce the same gonadal hormones, progesterone, testosterone, dhea and estradiol. Typically, replacement for men and women starts with testosterone, progesterone, and dhea typically starting at about age 30 years when hypogonadism begins. As the gonads of women become close to depletion estradiol should be added. The metabolic pathways of adults never change, and to function properly require replacement to adult gonadal hormone levels at all ages.
Hormone replacement therapy is one of the most successful areas of medicine. HRT for thyroid, cortisol, growth hormone, and insulin replacement and is so successful because it is done with pure hormones that are measured and monitored. The same care should be used when using HRT for hypogonadism so that the same success can be achieved.
The NIH recommendation to not seek treatment for hypogonadism is based on the negative outcome of the Women's Health Initiative. This recommendation is a result of correlating the effects of non-HRT, Premarin™, that was used in the WHI and eugonadal hormone replacement. The study drug, Premarin™, does not replace any gonadal hormone and has never been approved by the FDA as replacement for any gonadal hormone. When used in profoundly hypogonadal women, Premarin™ will worsen profound hypogonadism by creating severe hypoandrogenism (every free androgen level is reduced by at least half) and severe hypoprogesteronism. Premarin™ also causes hyperestrogenism with estradiol equivalent levels that exceed ovulation levels all day, every day. What caused the women in the WHI to get sick was years of enduring manufactured endocrinopathies.
Please treat my hypogonadism in a safe and effective way using eugonadal hormone replacement.