Ep. 246 Hormone Replacement Therapy in Menopause: Risks, Benefits, and Myths Debunked with Dr. Kelly Casperson

Menopause isn’t just a diagnosis—it’s a transition, and the way we treat it needs to change. Dr. Kelly Casperson joins Dr. Suzette Sutherland in this urogynecology crossover episode of BackTable to challenge outdated beliefs about menopause and hormone replacement therapy (HRT). They revisit the impact of the 1990s Women’s Health Initiative (WHI) study and explain how its findings—especially around synthetic hormones—were widely misinterpreted and continue to adversely influence patient and provider decisions today.

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SYNPOSIS

Dr. Casperson breaks down the differences between the hormones used in WHI and the safer, more targeted options available today. The conversation explores the broad benefits of modern HRT, including reduced risks of cardiovascular disease, osteoporosis-related fractures, and even dementia. Beyond the science, the episode also addresses the urgent need for better medical education and updated guidelines around menopause care.
Dr. Casperson and Dr. Sutherland make the case for empowering patients through informed consent and better clinician training. They also discuss Dr. Casperson’s upcoming book, The Menopause Moment, which aims to equip women with the tools and knowledge to navigate this life stage with confidence.

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TIMESTAMPS

00:00 - Introduction
02:50 - Focus on Menopause and Hormone Replacement Therapy
04:20 - The Women's Health Initiative (WHI) Study
05:39 - Understanding Risks and Misconceptions
12:43 - Reevaluation of the Women’s Health Initiative Study
18:31 - Impact of Media and Physician Education
19:58 - Current State of Hormone Therapy
22:17 - Broader Implications and Future Directions
27:17 - Evaluating FDA Warnings and Gender Bias in Hormone Treatments
29:49 - The Impact of Hormone Therapy on Women's Health
32:11 - Risks of Not Using Hormones
35:44 - Hormones and Brain Health: Debunking Myths
40:41 - The Timing Hypothesis and Long-Term Hormone Use
46:32 - Advocacy and Education for Menopause Awareness
48:04 - Conclusion and Upcoming Resources

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RESOURCES

PBS: The M Factor: Shredding the Silence on Menopause:
https://www.pbs.org/show/the-m-factor-shredding-the-silence-on-menopause/

The Menopause Moment by Dr. Kelly Casperson: https://kellycaspersonmd.com/the-menopause-moment-book/

Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10625913/