Is Hormone Therapy For You?


Ladies from the 1970’s terrified generations to come about the use of  HRT but the door may be opening again for menopausal women suffering from hot flashes and night sweats.  Relief may be at hand but is hormone therapy for you?

 On Sept. 29, 2017 Dr. Ronald Klatz, President of the A4M comments, “We at the Academy of Anti-Aging Medicine and World whole-heartedly agree with this study. We have been teaching HRT for nearly 20 years, the pros definitely outweigh the cons. I have believed for the past 20 years or so that HRT yields massive benefits for all seniors and pre-seniors in this case. We have always felt that hormone therapy for women is very beneficial, this study just confirms what thousands of doctors around the world already know.”

Hormone replacement therapy to treat symptoms of menopause does not increase a woman’s risk of early death — either overall or specifically from cancer or heart disease, according to long-term findings from the largest clinical trial conducted on hormone therapy.


Women who took estrogen for an average of seven years or combination estrogen and progesterone therapy for an average of five years had no increased risk of death after 18 years of follow-up, compared with women given an inactive placebo, the researchers found.

The clinical trial “provides support for the use of hormone therapy for treatment of bothersome and distressing hot flashes, night sweats and other menopausal symptoms that may impair quality of life in women who don’t have a reason not to take hormone therapy,” said lead author Dr. JoAnn Manson. She is chief of preventive medicine at Brigham and Women’s Hospital in Boston.

These latest results from the Women’s Health Initiative (WHI) trials shed more nuanced light on findings published in 2002 from the same study, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

The 2002 report found that hormone replacement therapy increased women’s risk of breast cancer and stroke, Lichtenfeld said. After that, many doctors became reluctant to prescribe hormone therapy for menopause symptoms.

The new update shows that women are not more likely to die after using hormone replacement therapy, even if the therapy increases their risk of health problems such as breast cancer, stroke and heart disease, Lichtenfeld said.

“There is a risk of adverse events, but those adverse events don’t lead to premature death,” Lichtenfeld said.

Women now must decide whether they wish to take the risks of nonfatal events by using hormonal therapy, with the understanding that it doesn’t appear to change overall life span, Lichtenfeld added.


Menopause is defined as a woman’s last menstrual period, occurring at an average age of 51, according to the North American Menopause Society. This natural life event leads to lower levels of estrogen and other hormones, which can cause discomfort for some women.

Estrogen alone can be prescribed to women who have had a hysterectomy, Manson said. For others, progesterone is also given to protect against increased risk of cancer of the uterus from estrogen therapy.

The WHI trial tracked more than 27,000 women, average age 63, who received either hormone replacement therapy or a placebo between 1993 and 1998.

After 18 years — including 10 to 12 years of follow-up after women ceased hormone therapy — researchers behind the new review found no positive or negative effect on death rate linked to treatment with either estrogen, or estrogen plus progesterone.

Manson said the lack of impact on death rate from any cause is more important than the findings associated with death rate from cancer or heart disease.

“When you’re testing a medication that has a complex pattern of benefits and risks, all-cause or total mortality is the ultimate bottom line when assessing the net effect of a medication on serious or life-threatening outcomes,” Manson said.

Cancer-related deaths linked to combination estrogen/progesterone therapy appeared to be a wash, as the treatment increased risk of breast cancer but decreased the risk of uterine cancer, Manson said.

“We found that hormone therapy really didn’t affect most other types of cancer, so the overall effect of hormones on cancer deaths was neutral,” Manson said.

Lichtenfeld brought up another point: Women on hormone therapy may not be more likely to die from cancer or heart disease because doctors have gotten better at treating those diseases, he said.

“It’s reasonable to consider that better treatments have improved the outlook for these illnesses,” he said.

Lichtenfeld also emphasized that the hormone replacement given to the women was temporary in this trial.

“This study does not mean that a woman can nonchalantly start hormone therapy and stay on it for the rest of her life,” he said. Study participants received “a modest term of hormonal therapy to deal with the immediate symptoms” of menopause, Lichtenfeld explained.

Manson added that the study only included estrogen and progesterone in pill form, since that was the only formulation available at the time. Women now have access to hormone therapy that is absorbed through the skin via patch, gel or spray, plus the ability to receive lower doses than were used in the WHI trial.

“We need more research on the benefits and risks of some of these newer formulations,” Manson said.

The trial results were published in the Sept. 12 issue of the Journal of the American Medical Association.


We find that people are either very for or very against the use of hormones, so where does your opinion fall (please feel free to comment here on the blog)

My feelings are that like medication, it is only as good as the doctor prescribing it and the monitoring performed.  I agree totally that you cannot just take a medication and stay on it indefinitely without adjustment.  I also feel that we have come a long long way since the HRT of the 1970’s.  The hormones prescribed were of a standard does and of equine source – right there every woman sees a problem, first we are not horses (duh) and second, our hormones are not released in a uniform way throughout the month so how can they be prescribed in a standardized does, the same amount for every woman?

The body is too smart for synthetic hormones.  The term “bioidentical” is crucial here as a hormone has to be identical to be recognized by its receptor.  Imagine having a key which was similar to the one needed to unlock a lock.  There is a good chance that similar key is going to get stuck in the lock and cause problems – same with a synthetic hormone.

To compare the HRT of the 70’s with the bioidentical hormones of today would be a huge mistake.


I have seen a number of ladies in my office incredibly upset with the emotions and weight gain they have suffered since being prescribed estrogen and estrogen alone.  It might be a cream or that estrogen patch but it resulted in a 5-15lb weight gain – all in the midsection,  I am not a doctor and I am not going to suggest I am even an authority of the subject, but I am a woman who has experienced and has read enough to know that estrogen therapy alone makes no sense.

Women produce both estrogen and progesterone, it is a very fine balance.  Both hormones decline with age although progesterone declines at a faster rate. ironically leaving us with estrogen dominance.  If estrogen and progesterone are declining together but progesterone drops faster the difference between the 2 hormones increases (see chart) so even though both hormones are declining, estrogen becomes “dominant”

estrogen dominance

Premenopausal women (that would be me) recognize this with mood changes (pessimism, worry), sleep issues, water retention, and weight gain.

So, we are premenopausal (estrogen is declining yet dominant) and then we slap on an estrogen patch, making the situation even worse!  A lot of the women I work with are diligent with their nutrition and training, so when they gain 10lb for no apparent reason it is incredibly upsetting.

Estrogen also promotes cell proliferation (hence its link to cancer) so to use it alone would seem unwise. It seems pretty obvious that as women we need to preserve the balance of estrogen and progesterone as long as we can and this means regularly checking our blood work at the right time of the month.  Little can be understood if you do blood work at the beginning of a cycle when progesterone is non existent and estrogen is low.

Men are pretty simple creatures (had to say it :)) and their testosterone levels can be checked anytime to get an accurate reading but we women are more complex, we have lived the ups and downs of our hormones since being teenagers and we know no two days are the same. To understate the importance of our hormonal cycle would be another mistake

 PERSONAL DECISION – is hormone therapy for you?

HRT is a very personal decision but I suggest you not base that decision on the experiences of your mother or elderly aunt. Is it a coincidence that most diseases and illnesses start to occur when our hormones start to decline?  Hormones and especially hormonal balance is our protective shield.  Too much or too little of any hormone can create a diseased state and this is the point I felt I needed to make in this blog post.

The most important decision you make when it comes to HRT is the doctor you chose to work with.  If a doctor does not advise you when to do your lab work or if a doctor suggests estrogen therapy only it may be a red flag.

Personally, I am lucky enough to work with Dr Howard Elkin at the Heartwise institute in CA – be sure to sign up to his blog at

Hope you enjoyed this post, be sure to subscribe and leave comments or questions




Ladies over 35 hormones running wild

Ladies, it can all start in your mid 30’s, your hormones start to run wild, creating chaos with your mind, mood and body

Women deal with periods, PMS, pregnancy, post-pregnancy, PCOS, perimenopause until finally menopause. Men just get old!

Ladies we deal with so much, for decades no two weeks are the same with constant body fluctuations. In our 30’s and 40’s what looms on the horizon is the dreaded “Change”. Menopause the official step into maturity. The reality is, however, is that the tricky time is actually before we enter menopause and can last several years. So here is a little overview on what to expect and how to maybe make things a little better.


As women, we have 2 hormones dancing around each month, Estrogen and Progesterone. As we age both start to decline but it is progesterone that declines most rapidly. Although both hormones are dropping it is the greater decline of progesterone that increases the ratio between the 2 hormones and leaves us with estrogen dominance.

The reason we call it Estrogen dominance is because although estrogen is declining the gap between estrogen and progesterone is even greater because of the progesterone drop.
Estrogen dominance can be absolutely miserable because of mood changes (the glass becomes half empty and anxiety can set in), PMS that seems to last weeks with greater water retention and bloating and noticeable weight gain around the middle


Bloodwork may show the decline in both hormones and I have seen some clients treated with estrogen therapy, this, however, can make the situation worse, making a lady, even more, estrogen dominant.
The answer depends on you. Many ladies are against any type of hormone therapy. For those ladies, it is best to keep a low carbohydrate diet as estrogen and insulin are the devil’s playmates and will add to your waistline. For the other ladies, it is well worth exploring the use of a bioidentical progesterone.
I will speak only of my experience as I started using progesterone when I was 47. The water retention that was driving me crazy subsided in just a few days and my mood lifted almost immediately.
I am a pretty cheerful lady and that was the worst. My thoughts we a little depressed and my drive and motivation was stuck in park.

Knowledge is key ladies and I am not trying to sway you in either direction but if you have started to notice some changes but know that you are not menopausal due to a regular cycle it may be a good idea to get a hormonal blood panel from your doctor and have “that: conversation.

If you want a little help finding the right doctor let us know and we can maybe help you with that and if you would like a nutrition plan based on these hormonal years then please get in touch as this subject is one close to my heart.

If sleep is an issue as it is with so many, click on the image below or go to Amazon and search The Shrink Shop sleep Formula.  Much more than melatonin.  12 all natural potent herbs to get you to sleep and to keep you asleep.  Absolutely our favorite product

Ladies over 35 I know its all getting a little cra cra but I hoped this explained why your hormones are running wild and how to help

Let’s get this party started! Who, What, Why

Ladies and Gents born after say 1985, this blog is for you.  Once we get into our mid 30’s things start to change.

What worked before isn’t working anymore, taking your shirt off or wearing a bikini becomes more uncomfortable and it seems like your body is working against you.  Before you resign yourself to “middle age” please start reading and watching this blog.


Everything that is happening to you can be explained and its really quite fascinating once you start to figure out what is going on and what you can do about it.  I will tell you right now that counting calories and adding minutes to your cardio will do very little to help.  Intake and expenditure are important but its a little like focusing on what color to paint a room when the house is built on sand.

Who am I?  Joanne Lee Cornish, you can read full bio in the sidebar.  I was a pro bodybuilder and although I hate to dig up old photos I probably will just to show you I know what I am talking about 🙂  I am 50 and I was an Independent trainer in Gold Gym Venice, CA for 24 years.  I think few will dispute that I made my mark there and was classed as one of the top trainers in the most famous gym in the world.  Outside of Golds I had (and still have), a nutrition business called  The Shrink Shop (hence the name of this blog) Although the name suggests weight loss, my niche is really conditioning and that may be adding muscle and/or losing fat.

I’ve been designing meal plans for over 20 years but about 10 years ago I wrote a seminar series called “If Diets Worked We’d All Be Skinny” it was a 6 part series where I explained everything from childhood obesity to bloating, hormonal weight gain, alcohol, sleep, stress and of course nutrition.  Well, seminar #1 I presented to about 6 of my friends who were kind enough to turn up to support me.  By seminar #6 we were at capacity with people standing in the hallway taking notes.  I was asked to repeat the whole series which I did but we had to move to a larger location.

Does that mean I’m so great?  not really.  What was obvious was that people were really interested in understanding what was going on with their bodies, behaviors and were looking for solutions they could implement with confidence.  This was a game changer for me, as i really find all this stuff totally fascinating but I hadn’t realized so many people felt the same way.

This blog is intended to be informative and fun.  If you have any questions or ideas please let me know

The Shrink Shop was founded on the belief that given clear, valid information, people will make better choices all by themselves.

So let’s get started!

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