Guest Bio
Avrum Bluming, MD
Avrum Bluming received his MD from the Columbia College of Physicians and Surgeons. He spent four years as a senior investigator for the National Cancer Institute and for two of those years was director of the Lymphoma Treatment Center in Kampala, Uganda. He organized the first study of lumpectomy for the treatment of breast cancer in Southern California in 1978, and for more than two decades he has been studying the benefits and risks of hormone replacement therapy administered to women with a history of breast cancer.
Dr. Bluming has served as a clinical professor of medicine at USC and has been an invited speaker at the Royal College of Physicians in London and the Pasteur Institute in Paris. He was elected to mastership in the American College of Physicians, an honor accorded to only five hundred of the over one hundred thousand board-certified internists in this country.
Carol Tavris, PhD
Carol Tavris received her PhD in social psychology from the University of Michigan. Her books include Mistakes Were Made (But Not by Me), with Elliot Aronson; Anger: The Misunderstood Emotion, and The Mismeasure of Woman. She has written articles, op-eds, and book reviews on topics in psychological science for a wide array of publications — including the Los Angeles Times, the New York Times Book Review, the Wall Street Journal, and the TLS — and a column, “The Gadfly,” for Skeptic magazine. She is a fellow of the Association for Psychological Science and has received numerous awards for her efforts to promote gender equality, science, and skepticism.
In This Episode We Discuss
- What happens to estrogen in menopause? What symptoms are caused by this change in estrogen?
- Hormone replacement therapy
- Issues with the Women’s Health Initiative (2002) that suggested women taking HRT had an increased risk of breast cancer
- Potential benefits of HRT
- Impact of hormone replacement therapy on heart disease risk
- Criticisms and evidence against HRT
- Who should and shouldn’t consider HRT?
Links & Resources
- Estrogen Matters
- For questions about content of this discussion, you can email Dr. Bluming on: avrumzbluming@gmail.com
Comments
Hi. I just found this podcast. Thank you so much for talking about menopause. I’m 52 and always trying to find more information but it’s not the most popular of topics! I’m a PT and so have a healthy lifestyle but am wondering if I can benefit from HRT as I find it very hard to gain muscle growth and do have sweats and hot flushes. I will be speaking to my GP about the options. Thanks again 😁
Thanks so much Tansy, I’m glad you found it insightful.
I think this is certainly a conversation to have with your doctor to see if HRT is right for you. Hopefully this episode gave you some information that can allow you to ask informed questions and to have a productive discussion with your GP.
Thanks for listening!
I have a question for Carol. I am 63 years old and never took HRT. Why did you say that it is not recommendable to start now? I do not mind vaginal dryness, mood changes, night sweats , hot flashes because except for vaginal dryness which I do not mind, I have not had those other symptoms, but I am concerned about my testosterone levels which is lower than 3. Now I have osteoporosis, and I want to build more muscle, which it makes pretty impossible with such low testosterone levels, so because of all of this, why cannot start on HRT? I do not have family with breast cancer, so my risk is low, I do have an aunt dying from uterus cancer though, so here is my question. What do you recommend for me?
Hi Viviana,
You will have to direct any personal medical questions to an appropriate medical professional. If you wish to contact Dr. Bluming, his email is in the show notes above.
While I don’t want to speak on Dr. Tavris’ behalf, typically the recommendation for HRT to be aimed at women under 60 is that the data that shows it results in a decrease in CVD risk is in those where therapy was started under the age of 60 or within 10 years of menopause. So in general, the risk-to-reward ratio is more beneficial for this group, because of the level of evidence.
However, for any individual, the specifics of their case may be different. Hence why it’s important to discuss this with your doctor or specialist.
Hope this helps!
Why contraindicated for women beyond 10 year window? Is there data to support this?
Hi M.E.,
Typically the recommendation for HRT to be aimed at women under 60 is that the data that shows it results in a decrease in CVD risk is in those where therapy was started under the age of 60 or within 10 years of menopause. So in general, the risk-to-reward ratio is more beneficial for this group, because of the level of evidence. However, for any individual, the specifics of their case may be different. So individuals should discuss this with their doctor or specialist.
Hello, can you tell me where to find the supporting evidence of Bluming’s statement that statins do not prevent heart attacks as primary prevention in menopausal women? I looked at the American Heart Association’s website trying to find some sort of statement on this, and couldn’t find anything. I also recently heard this claim in another US based podcast … while I understand that Hormone Replacement therapy can help with menopausal symptoms and osteoporosis, the US Doctor Gynecologist author of the menopause manifesto, Dr. Jen Gunter, says there is no science backed evidence/ studies that show HRT prevents Cardiovascular Disease. Can you point me to a study that proves it does? I just now listened to this particular episode on estrogen as I am 53 and in menopause with very mild symptoms … I have been listening to you for the past few years and really love how you explain scientific studies, although I admit it hurts my brain sometimes, lol, but I really try to understand it all. Thank you!
Hi Monique,
I don’t want to speak on behalf of Dr. Bluming, nor could I as this is not an area I have exertise in. You can email Dr. Bluming on the following email address, at which I believe he is happy to take questions: avrumzbluming@gmail.com