The results of the Kronos Early Estrogen Prevention Study (KEEPS) were released at the 23rd annual meeting of the North American Menopause Society (NAMS) in October 2012. The conclusion: Bio-identical hormones (estradiol and micronized progesterone) – started soon after the start of menopause – improved depression, anxiety, and cognitive function in healthy women. But, perhaps most importantly, bio-identical hormones did this without posing any cardiovascular disease risk, and were shown to be superior to synthetic conjugated equine estrogens (CEE). CEE are made by pregnant mares and are not bio-identical to hormones naturally made by women. CEE are the form of hormones that were used in the Women’s Health Initiative (WHI), a large government-sponsored study published in July 2002. The WHI found an increased risk of breast cancer associated with CEE, and incited fear in women and their physicians leading to a major decrease in prescribing of synthetic hormones such as CEE. At that time, many women and health care professionals began to seek information on options such as bio-identical hormones.
Dr. Sanjay Asthana noted, “… the form of progesterone used in WHI, medroxyprogesterone, is very different than the form that KEEPS used, which is micronized progesterone, the more natural form of progesterone. We certainly did not see any adverse effects with this type of progesterone [i.e., micronized progesterone].” Transdermal bio-identical estrogen appeared to provide an additional important benefit of improving insulin sensitivity.
Margery Gass, MD, executive director of the North American Menopause Society, told Medscape Medical News, “This is a very well-designed study that [can] provide clinicians with the evidence to tailor the hormone therapy even more for women so that they could get the most benefit and the least risk. Tailoring it to their needs is going to be so important…”
The KEEPS preliminary findings presented at NAMS will be submitted for publication in a medical journal after the results are peer-reviewed, the researchers noted.