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We applaud the letter from the Women’s Health Initiative advising women to stop taking horse estrogen and progestin. This advice is years overdue, and demonstrates for at least the thousandth time that long-term use of therapies foreign to human bodies is likely to be dangerous.

Women’s bodies have never contained equilin (the principal horse estrogen component of Premarin), medroxyprogesterone (Provera), or any other “progestin”. Women’s bodies have always contained 17-beta estradiol, estrone, 2-hydroxyestrone, estriol, and other human estrogens.

Since the early 1980s, when medically indicated, our clinic has prescribed bio-identical hormone therapy (using hormones identical to those found in women’s bodies) with notable benefit for women with menopausal symptoms, osteoporosis, heart disease, and other problems. We monitor the safety of this therapy in several ways, including an FDA-approved urine test to estimate the risk of estrogen-related cancer.

While no therapy is completely risk free, in approximately 20 years we’ve observed very, very few adverse effects. Bio-identical hormone therapy is far and away less risky than the use of horse urine and progestins, which women should surely avoid.

-Jonathan V. Wright, MD