Women to Women, one of the nation's leading providers of women's health-care and medical information, spoke out on Nov. 21 on the controversy surrounding Suzanne Somers' new book, Ageless, in which she advocates lifelong use of bioidentical hormones.
Marcelle Pick, NP, co-founder of Women to Women, explains, "Having watched the Larry King show this week on Suzanne Somers, I have to say that this controversy has become a disservice to women. The real choices women have to deal with menopause symptoms are getting lost in the name-calling and misinformation. The effect is to leave women confused and feeling there's nowhere to turn and no one they can trust.
"Having used compounded bioidentical hormones in our medical practice for over 15 years, we want to sort out fact from fiction so women can make choices that are right for them. And they do have good choices!"
Marcy Holmes, NP, certified menopause clinician at Women to Women, agrees. "The people attacking Suzanne Somers are saying that bioidentical hormones are dangerous, or at least as dangerous as synthetic HRT. While the evidence isn't perfect, what we know to date clearly shows the risks of bioidentical hormones are lower than conventional HRT. Study after study has shown that conventional HRT carries serious health risks, and our clinical practice confirms that. There simply aren't comparable studies for compounded bioidentical hormones. In our clinic, however, we have treated over 10,000 women with compounded bioidentical hormones and we have not seen significant side effects or risks from usage."
Marcelle Pick, who helped pioneer the use of bioidentical hormones in America, adds, "We were among the very first to use compounded bioidentical hormones in America, and I still prescribe them daily. In all that time, I've seen minimal evidence of unusual side effects or long-term health problems. The opposite is true of women who come to me on Prempro and Premarin, the major forms of conventional HRT."
"It's hard to separate money from science. Who would be willing to fund a large-scale longitudinal study on the safety of compounded bioidentical hormones, which would cost millions of dollars? They can't be patented, so no drug company will.
"And let's be frank here. Some of the doctors who are most critical of Suzanne Somers — including Wolf Utian, who appeared on the Larry King show this week — are paid in one way or another by the pharmaceutical companies, whose profits are threatened by widespread use of compounded bioidentical hormones. So instead of attacking the flaws within Somers' program, they go after bioidentical hormones as a whole. That's their real target; Suzanne is just a convenient means to that end."
Marcy Holmes interjects, "But Suzanne Somers clearly invites criticism. For example, she says that bioidentical hormones aren't drugs. That's going too far. Of course they're drugs, and they should be taken with great caution. And the notion that a 60-year-old woman should take drugs so she has the hormonal levels of a 20-year-old — especially on an indefinite basis — is both untested and unnatural. How does it make sense to say natural is best and then advocate something so completely unnatural?"
Ms. Pick continued, "That's right, it isn't natural at all. Maybe worse, it isn't necessary either. The level of hormones a 60-year-old would have to take to match a 20-year-old is pretty high. And I know from my practice that almost all 60-year-old women can feel fabulous either without hormones or with just a small supplement. So why recommend that all women take more than is necessary?"
Ms. Holmes joined in. "I have particular problems with the Wiley Protocol, which Suzanne Somers recommends in her book," she said. "Wiley has been criticized for not having any medical qualifications, but frankly that's not the real problem. A medical degree is no guarantee of being objective or right. The bigger issue is that she's making or implying cure-all claims about compounded bioidentical hormones for which there is no scientific evidence. She cites her own study of 80 women, but that sample size is so small it's irresponsible."
"And there's also a big issue here that no one has mentioned," said Ms. Pick, "but it must be mentioned. Who wants to have periods till they're 90? What's so great about riding the ups and downs of a menstrual cycle forever? I would ask each woman to remember the best day of her average menstrual cycle — the creativity, confidence, and vitality of that day. Well, in menopause, every day should be like that. And it can be."
"That's the ideal outcome," said Ms. Holmes, "but a significant percentage of women need hormone supplementation to reach that point. We think those women are best served by bioidentical hormones. Keep in mind that there is a middle ground here. Compounded bioidentical hormones at the center of this controversy are prepared by a special pharmacy under the direction of your medical practitioner in doses matched to your needs. But other bioidentical hormones are available in a number of doses from conventional pharmaceutical companies under names like Vivelle, Climara, and Prometrium, just to name a few. These drugs have been through standard FDA trials and are shown to have fewer risks than Premarin or Prempro. We've also used these drugs in our clinical practice for years with good outcomes. So women really do have good choices. To try to limit those choices is a disservice to women, and all women should oppose it."
"You're right, that's the immediate danger," Ms. Pick agreed. "But I feel another disservice is being done to women by the message the media attributes to Suzanne Somers. The message is that women at 60 should look and feel like a 20-year-old and that they can with a magic pill. Of course Ms. Somers looks wonderful and many women obviously wish they looked that good as well.
"What I wish the media would emphasize instead is what a go-getter Suzanne is, how full of energy and vitality she is, how hard she worked to find her path to wellness. And that she has done tremendous work on her health, starting with exercise and diet and the right nutritional supplements. Only at the end of that process, when she still didn't feel great, did she search out and begin using bioidentical hormones. Every woman can and should work through those same basic stages, and if they did, the great majority wouldn't need bioidentical hormones at all. But for those few who, like Suzanne, might still need them, the choice to use them should continue to be available to them. The bottom line is this: no hormone supplement is a magic bullet, but the choice to use them belongs in the hands of women because each woman is her own authority and her body is the expert she should trust."
To learn more about bioidentical hormones and whether they're right for you, refer to the Women to Women Web site, which brings straight talk on health to millions of women each year, including the risks of synthetic HRT and how to talk to your doctor about bioidentical hormones.
