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Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women's Well-Being and Lengthen Their Lives -- Without Raising the Risk of Breast Cancer
A compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health.
For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flashes to memory loss; reduce the risk of heart disease, Alzheimer's, osteoporosis, and some cancers; and even extend a woman's overall life expectancy. But when a large study by the Women's Health Initiative announced results showing an uptick in breast cancer among women taking HRT, the winds shifted abruptly, and HRT, officially deemed a carcinogen, was abandoned.
Now, sixteen years after HRT was left for dead, Dr. Bluming, a medical oncologist, and Dr. Tavris, a social psychologist, track its strange history and present a compelling case for its resurrection. They investigate what led the public -- and much of the medical establishment -- to accept the Women's Health Initiative's often exaggerated claims, while also providing a fuller picture of the science that supports HRT.
A sobering and revelatory read, Estrogen Matters sets the record straight on this beneficial treatment and provides an empowering path to wellness for women everywhere.
For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flashes to memory loss; reduce the risk of heart disease, Alzheimer's, osteoporosis, and some cancers; and even extend a woman's overall life expectancy. But when a large study by the Women's Health Initiative announced results showing an uptick in breast cancer among women taking HRT, the winds shifted abruptly, and HRT, officially deemed a carcinogen, was abandoned.
Now, sixteen years after HRT was left for dead, Dr. Bluming, a medical oncologist, and Dr. Tavris, a social psychologist, track its strange history and present a compelling case for its resurrection. They investigate what led the public -- and much of the medical establishment -- to accept the Women's Health Initiative's often exaggerated claims, while also providing a fuller picture of the science that supports HRT.
A sobering and revelatory read, Estrogen Matters sets the record straight on this beneficial treatment and provides an empowering path to wellness for women everywhere.
310 pages, Hardcover
Published September 4, 2018
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Displaying 1 - 30 of 388 reviews
February 16, 2020
If I could, I would send a copy of this book to every woman over the age of 30, and pay her to read it. I consider it on the order of books like Good Calories, Bad Calories. As Gary Taubes thoroughly debunked decades of nutrition recommendations like carb-heavy diets and commonly held, wrong beliefs like "fat makes you fat," so Bluming and Tavris methodically examine and deflate commonly held, wrong beliefs like "Estrogen causes cancer," which it does not.
This is an important book, because it is a counterpoint to commonly held, wrong beliefs that women must confront at medical appointments and even on prescription drug inserts for HRT, which still cite the 2002 WHI study that Bluming and Tavris make clear was exaggerated and misinterpreted. Indeed, the study's authors drew conclusions and made recommendations that were not supported by their own data.
Before listening to a doctor or believing a prescription insert wholesale, women should do their own research and read this book. Doing so may help them feel better without believing they must increase their cancer risk in order to do so. Many women struggle with debilitating depression and anxiety, for example, and receive prescriptions for antidepressants that don't work...because their depression is caused by hormone levels, fundamentally, and antidepressants don't address those. Other women blame themselves for "giving themselves" cancer because they took HRT to stop themselves from losing their minds, and that's sad, unnecessary, and not true. For these and so many reasons, I recommend this clear and accessibly written book that makes decades of science understandable, and explains why what we think we know just ain't so.
This is an important book, because it is a counterpoint to commonly held, wrong beliefs that women must confront at medical appointments and even on prescription drug inserts for HRT, which still cite the 2002 WHI study that Bluming and Tavris make clear was exaggerated and misinterpreted. Indeed, the study's authors drew conclusions and made recommendations that were not supported by their own data.
Before listening to a doctor or believing a prescription insert wholesale, women should do their own research and read this book. Doing so may help them feel better without believing they must increase their cancer risk in order to do so. Many women struggle with debilitating depression and anxiety, for example, and receive prescriptions for antidepressants that don't work...because their depression is caused by hormone levels, fundamentally, and antidepressants don't address those. Other women blame themselves for "giving themselves" cancer because they took HRT to stop themselves from losing their minds, and that's sad, unnecessary, and not true. For these and so many reasons, I recommend this clear and accessibly written book that makes decades of science understandable, and explains why what we think we know just ain't so.
March 11, 2019
I found this book after hearing the authors on Peter Attia's podcast. The book did a great job of continuing the conversation i heard on the show.
It appears that HRT is essential to the long term health of women and I have already started conversations with the women in my life. The book lays out in detail the shortcomings of the Women's Health Initiative study and why HRT actually works for most women.
This book is not just for women. Men also would benefit from learning about HRT so that they can best support and understand the changes that happen in women in their lives.
It appears that HRT is essential to the long term health of women and I have already started conversations with the women in my life. The book lays out in detail the shortcomings of the Women's Health Initiative study and why HRT actually works for most women.
This book is not just for women. Men also would benefit from learning about HRT so that they can best support and understand the changes that happen in women in their lives.
October 30, 2018
I’d like to read some more reviews especially ones by medical professionals. The benefits of HRT presented seem to outweigh minimal risks. If the basis of this book is true, shame on the WHI doctor’s for robbing so many women of better, stronger later years.
January 1, 2020
This is a competent review of the benefits and risks of hormone replacement therapy (should we just call it hormone therapy?).
The authors' conclusion is that the benefits (menopause symptoms like hot flashes and depression; cardiovascular disease risk; Alzhiemer's disease risk) far outweigh the risks (purportedly, breast cancer risk). The CVD and Alzheimer's piece only works for women who start therapy within 10 years of menopause and stay on HRT. Little utility if you start e.g. in your 60s or if you drop off afterwards. [Note: John Ioannidis at Stanford apparently doesn't agree with this conclusion, so take it with a grain of salt. I haven't read any of this literature myself and am taking things on faith.]
The book is interesting when considered in the context of many medical professionals who aren't comfortable prescribing HRT, largely in the wake of a 2002 publication from the Women's Health Initiative that indicated a (statistically insignificant) higher risk of breast cancer in an HRT cohort versus a control group. To this day one botched study has cost American women probably hundreds of thousands or millions or more of quality-adjusted life years. The number keeps on going up because misconceptions still haven't been corrected. I dare you to ask your favorite doctor over age 50 what they think of HRT.
This highlights a theme I've been thinking a bit about, the danger of first principles thinking in medicine:
Medical education in the United States is horrifyingly bad in many ways. But one of the most insidious things is the way you are encouraged to think about interventions and their molecular mechanisms. Tamoxifen is an estrogen receptor antagonist and we use it to treat cancer. So more estrogen must be cancer-promoting, right? Integral of serum estrogen == disease risk right? This is as wrong as our thinking on statins (we thought they inhibit cholesterol synthesis, which they do, but most of the therapeutic effect comes from upregulating LDL receptor expression). We don't know all the variables we are playing with in biology. Biology is messy. We generally don't know what binds to what in what cells in vivo, with what precise downstream results. There's one type of trustworthy evidence* and that's a randomized, controlled, double-blind study measuring the outcome of interest and not some surrogate marker. Period. Everything else might be informative but can also be extremely misleading.
*Observational studies with massive effect sizes that are concordant across studied populations like lung cancer and smoking, or chimney sweeps and scrotal cancer are also acceptable.
I would have liked more reflection on how the WHI got so messed up and what led the authors to publish what they did. Another good example leading me to think scientific institutions need a good hard look and some form of renewal.
The authors' conclusion is that the benefits (menopause symptoms like hot flashes and depression; cardiovascular disease risk; Alzhiemer's disease risk) far outweigh the risks (purportedly, breast cancer risk). The CVD and Alzheimer's piece only works for women who start therapy within 10 years of menopause and stay on HRT. Little utility if you start e.g. in your 60s or if you drop off afterwards. [Note: John Ioannidis at Stanford apparently doesn't agree with this conclusion, so take it with a grain of salt. I haven't read any of this literature myself and am taking things on faith.]
The book is interesting when considered in the context of many medical professionals who aren't comfortable prescribing HRT, largely in the wake of a 2002 publication from the Women's Health Initiative that indicated a (statistically insignificant) higher risk of breast cancer in an HRT cohort versus a control group. To this day one botched study has cost American women probably hundreds of thousands or millions or more of quality-adjusted life years. The number keeps on going up because misconceptions still haven't been corrected. I dare you to ask your favorite doctor over age 50 what they think of HRT.
This highlights a theme I've been thinking a bit about, the danger of first principles thinking in medicine:
Medical education in the United States is horrifyingly bad in many ways. But one of the most insidious things is the way you are encouraged to think about interventions and their molecular mechanisms. Tamoxifen is an estrogen receptor antagonist and we use it to treat cancer. So more estrogen must be cancer-promoting, right? Integral of serum estrogen == disease risk right? This is as wrong as our thinking on statins (we thought they inhibit cholesterol synthesis, which they do, but most of the therapeutic effect comes from upregulating LDL receptor expression). We don't know all the variables we are playing with in biology. Biology is messy. We generally don't know what binds to what in what cells in vivo, with what precise downstream results. There's one type of trustworthy evidence* and that's a randomized, controlled, double-blind study measuring the outcome of interest and not some surrogate marker. Period. Everything else might be informative but can also be extremely misleading.
*Observational studies with massive effect sizes that are concordant across studied populations like lung cancer and smoking, or chimney sweeps and scrotal cancer are also acceptable.
I would have liked more reflection on how the WHI got so messed up and what led the authors to publish what they did. Another good example leading me to think scientific institutions need a good hard look and some form of renewal.
March 7, 2019
This is an important book for women with menopausal symptoms. Takeaways are that the WHI overstated the dangers of HRT, there can be serious health consequences for women who do not use HRT, and that women could continue to take estrogen longer than the standard 10 years. Less important but good to know was the information that none of the over-the-counter solutions for menopausal symptoms do anything. It was also quite interesting to read about all the medical world arguments over this subject, although there is more information here than some readers would require. I was not going to read the chapter called "Can Breast Cancer Survivors Take Estrogen?" because what's the point if one does not have cancer? It's actually a fascinating story of the author's efforts to study this and how he was hindered by FDA. In the end, his and other's research in this area showed that HRT does not contribute to cancer in those women. Personally, the book set my mind at rest about HRT as the benefits seem to outweigh the possible harm.
August 24, 2024
This should be required reading for every woman in their 40s or 50s! An eye-opening read on the science — and politics — behind hormone therapy and how bias has prevented generations of women from seeking the medical care they need and could benefit from. Spoiler alert: it's not risky for the vast majority of women and actually is beneficial beyond menopausal symptoms. I had little idea that hormone therapy could be so potentially impactful on preventative medicine, and it's frustrating that this book was published back in 2018 and still took until now to come across my radar. You don't need to be considering hormone therapy to read this book, but absolutely consider it a must read if you want a deeper understanding of the female body and how it has been impacted by modern medicine. Just about everything I thought I knew (and had been told) on this subject was wrong.
July 2, 2019
I wish this book had been available ten years ago so I could have advised my mother and other beloved women in my life to not fear hormone replacement therapy. This is an important deconstruction of how medicine gets dispersed through bad science and popular media. The messsge is presented clearly and makes the issue understandable. Highly recommend for anyone approaching menopause or cares about other women in that position. Everyone can learn something.
June 10, 2019
I recommend this book for all women over the age of 40.
I read this book after hearing an interview with the authors on Dr. Peter Attia's The Drive podcast. Check that out as well, but the book is more linear in its presentation of the information.
I read this book after hearing an interview with the authors on Dr. Peter Attia's The Drive podcast. Check that out as well, but the book is more linear in its presentation of the information.
July 14, 2024
Strongly one-sided. The book makes a lot of great points that people should be aware of, but it’s not a fair and balanced analysis. I’d recommend reading “The Menopause Manifesto” instead.
November 14, 2019
Started to educate myself on the women’s health matters and had lots of cross references to this book, was shocked by the data which authors presented. A must read to anyone who has loved ones coming close to menopause or is experiencing it herself.
July 10, 2019
This was an interesting book - pretty much the first book I've read on the subject matter, so I have a LOT to learn. The information was presented in a straight forward, factual way, but also very readable to a non-science person like me. I also appreciated finding the hidden bits of humor along the way! It definitely gives lots of info on both sides of the debate and it thoroughly researched. I do wish there was just a definitive answer, but that is probably too much to hope for. They do lay out their argument in a very convincing manner and they also present the opposite viewpoint as well.
August 29, 2022
Not a thrilling read (due to the immense amount of clinical studies, data, and statistics), but such important information! So I’m giving it 5 stars and highly recommending it.
March 9, 2025
4.5⭐️
July 10, 2026
Not in menopause… just a girl in NP school wanting to work in women’s health 🙃
March 14, 2024
3 stars is just because it’s not really gripping reading - not a commentary on the content. Despite the fact that this horrible book cover design makes the book look like it’s from the 1980s, it is fairly recent. Admittedly my brain wandered some during this book. There’s a lot of science and I lost the thread sometimes. I think the big takeaway is debunking some junk science that scared women off but that HRT is beneficial and safe for women to take but you should start it in the first decade of menopause (usually ages 50-60) and it’s not really going to help if you start later than that or take it and then stop. And bioidentical hormones are garbage.
September 4, 2026
Even though I was already familiar with a lot of this information from listening to interviews with the authors on podcasts, Estrogen Matters is still an absolute must-read. Having everything laid out in one place makes a huge difference.
It’s so tight, comprehensive, and thoughtful. Dr. Bluming and Carol Tavris seem to anticipate every single question, doubt, and thought you could possibly have about HRT. It’s the ultimate reference guide—the kind of book you keep on your shelf to flip back to again and again, and one you'll end up recommending to practically everyone you know.
If you want the whole shebang when it comes to taking charge of your health, I can't recommend this enough as a starting point. Pair it with The New Menopause (and The New Perimenopause) by Dr. Mary Claire Haver, Unbreakable by Dr. Vonda Wright, and Stacy Sims' book ROAR, and you'll have an incredible toolkit for navigating perimenopause and menopause.
❤️
It’s so tight, comprehensive, and thoughtful. Dr. Bluming and Carol Tavris seem to anticipate every single question, doubt, and thought you could possibly have about HRT. It’s the ultimate reference guide—the kind of book you keep on your shelf to flip back to again and again, and one you'll end up recommending to practically everyone you know.
If you want the whole shebang when it comes to taking charge of your health, I can't recommend this enough as a starting point. Pair it with The New Menopause (and The New Perimenopause) by Dr. Mary Claire Haver, Unbreakable by Dr. Vonda Wright, and Stacy Sims' book ROAR, and you'll have an incredible toolkit for navigating perimenopause and menopause.
❤️
April 21, 2019
The authors, oncologist and psychologist, tackle the Women’s Health Initiative which in 2002 advised that HRT and ERT were detrimental to women, a factor in increased breast cancer, heart disease, blood clots. In fact, the study was flawed and the results highly distorted. Estrogen is critical to women’s health, maybe even more after menopause, with studies finding its efficacy in helping prevent osteoporosis, protection against dementia, important for brain health, not increased risk of breast cancer, blood clots (if taken in non-pill form) or heart disease. A huge disservice to many women trying to manage menopause, the doctors recommend optimal time to begin and continue use of HRT. Well-documented, reasoned conclusions.)
January 21, 2024
Are you a woman? Do you believe in science? If yes, read this book.
February 8, 2024
A great summary of the literature as it relates to estrogen and progesterone. The science was presented as it relates to common misconceptions.
June 26, 2024
Worth reading for anyone whose doctor automatically says, 'You just have to live with menopause." Blah blah blah. No.
June 21, 2025
Thought Provoking
I decided to read this book after it was mentioned by AARP. After experiencing menopause and related undesirable symptoms, I was interested to read about an option (hormone replacement therapy) that might address the root cause of my discomfort vs. remedies that only alleviate symptoms.
The writing style of the book felt a little tabloid-like at times. Factual evidence was presented. But the way the authors chose to denounce the Women's Health Initiative and prevailing medical opinion on hormone replacement therapy seemed unprofessional at times and sometimes made me question their motives or grounding in fact.
In the end, I feel the information presented was valuable and will make me have a conversation with my doctors to choose the right course of treatment for my situation. The book reinforces the idea that we need to be actively engaged in our health outcomes. Doctors are human, and, just like us, subject to their own biases. But they should all be professionals and willing to stand up to an intelligent dialogue about the treatments they offer and the science behind them.
I decided to read this book after it was mentioned by AARP. After experiencing menopause and related undesirable symptoms, I was interested to read about an option (hormone replacement therapy) that might address the root cause of my discomfort vs. remedies that only alleviate symptoms.
The writing style of the book felt a little tabloid-like at times. Factual evidence was presented. But the way the authors chose to denounce the Women's Health Initiative and prevailing medical opinion on hormone replacement therapy seemed unprofessional at times and sometimes made me question their motives or grounding in fact.
In the end, I feel the information presented was valuable and will make me have a conversation with my doctors to choose the right course of treatment for my situation. The book reinforces the idea that we need to be actively engaged in our health outcomes. Doctors are human, and, just like us, subject to their own biases. But they should all be professionals and willing to stand up to an intelligent dialogue about the treatments they offer and the science behind them.
December 13, 2025
I would never have read this book if it wasn’t prescribed to me and I am very glad it was! Up until the very final chapter, I was 100% sold. But ironically the final chapter ‘a case for HRT’ introduced another point that made me pause again. But I feel a lot more equipped to consider options having read this and highly recommend it as a resource for knowing more to make better decisions for yourself.
July 1, 2026
Ever wondered if you should take hormones during perimenopause, menopause, or after? Then read this book.
Well researched and explained. Touches on many studies and delves more deeply into a few. Think of this as a well organized research paper for the common woman.
Well researched and explained. Touches on many studies and delves more deeply into a few. Think of this as a well organized research paper for the common woman.
June 25, 2026
It took me a while to finish this book because of the detailed medical data that I had to comprehend. This book provides clear evidence debunking the myth of HRT causing breast cancer. It completely put my mind at ease about the topic.
October 23, 2024
An excellent summary of pertinent recent scientific findings on the effectiveness of HRT on women's everything. And if you prefer to look up the primary sources, the citation list is incredibly extensive.
This book confirms so much of what I've been suspecting, and what had me running with symptoms of brain fog, cyclical depression, joint pain and occasional insomnia to gynecologists, neurologists, psychologists, orthopedists and general practitioners for years, none of whom took me seriously when I suggested to them it might be hormones. It is fucking hormones. HRT would fucking help. But I have yet to convince one of these numerous doctors to actually give it to me. Wish me luck.
This book confirms so much of what I've been suspecting, and what had me running with symptoms of brain fog, cyclical depression, joint pain and occasional insomnia to gynecologists, neurologists, psychologists, orthopedists and general practitioners for years, none of whom took me seriously when I suggested to them it might be hormones. It is fucking hormones. HRT would fucking help. But I have yet to convince one of these numerous doctors to actually give it to me. Wish me luck.
December 7, 2024
5 stars. Every woman my age needs to read this book. This is so, so important.
November 28, 2022
I rarely write reviews but if you’re a woman 45 or older you really should read this. Some of it was a bit clinical but every chapter was nicely summarized @ the end which was great. It is clearly a field / area that needs more study and research. Why is it so divisive? I hadn’t ever given a lot of thought to medical studies but now I see them in a while different light and realize I must do my own research on things and not blindly listen to headlines/news/studies. Women need to fight for our health and well-being.
September 30, 2023
I read this based on advice from my sister in law who is also a doctor. I was diagnosed with breast cancer last year and I have beat it. Now I am dealing with life after breast cancer. This book provides a lot of information that doesn't necessarily go with the normal standard of care. My oncologist was not happy about what I was reading. Educating yourself is key, that is what I'm trying to do. I want to live happy and healthy.
September 5, 2023
A few things to consider, but overall junk science. 4 out of 5 libraries where I am a patron do not have this book. The first book referenced in this book was likewise not in the stacks of 'my' libraries. Super short, so not too many hours wasted. The author's read it, so their bias is even more apparent on the audible version. Not worth the time or money, IMHO.
July 2, 2019
Very helpful information as I begin to research his topic for myself as a 45 year old. Heard the authors on Peter Attia’s podcast. I’m not sure I’ve made up my mind about bioidenticals versus traditional prescription HRT meds but I am sure some kind of hormone therapy is in my future.
Displaying 1 - 30 of 388 reviews