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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

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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.

270 pages, Kindle Edition

Published September 4, 2018

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6966 people want to read

About the author

Carol Tavris

84 books212 followers
Carol Tavris earned her Ph.D. in the interdisciplinary program in social psychology at the University of Michigan, and ever since has sought to bring research from the many fields of psychology to the public. She is author of The Mismeasure of Woman, which won the Distinguished Media Contribution Award from the American Association from Applied and Preventive Psychology, and the Heritage Publications Award from Division 35 of the APA. Dr. Tavris is also the author of Anger: The Misunderstood Emotion and coauthor with Carole Wade of Invitation to Psychology; Psychology in Perspective; Critical and Creative Thinking: The case of love and war; and The Longest War: Sex Differences in Perspective. She has written on psychological topics for many different magazines, journals, edited books, and newspapers, notably the Los Angeles Times and the New York Times. She has given keynote addresses and workshops on, among other topics, critical thinking, pseudoscience in psychology, anger, gender, and psychology and the media. She has taught in the psychology department at UCLA and at the Human Relations Center of the New School for Social Research in New York. Dr. Tavris is a Fellow of the American Psychological Association and a charter Fellow of the American Psychological Society; and, for fun, a Fellow of the Committee for the Scientific Investigation of Claims of the Paranormal. When she isn't writing or lecturing, she can be found walking the trails of the Santa Monica mountains with her border collie, Sophie.

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5 stars
1,184 (47%)
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291 (11%)
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Displaying 1 - 30 of 315 reviews
Profile Image for Stephany Wilkes.
Author 1 book35 followers
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.
Profile Image for Ryan Stevens.
145 reviews23 followers
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.
Profile Image for Lynda.
1,490 reviews16 followers
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.
Profile Image for Sebastian.
164 reviews34 followers
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.
Profile Image for Yycdaisy.
412 reviews
July 1, 2020
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.
Profile Image for Laura (thenerdygnomelife).
1,040 reviews2 followers
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.
Profile Image for Eileen Margaret.
373 reviews1 follower
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.
Profile Image for Richard.
175 reviews
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.
365 reviews
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.
Profile Image for Ekaterina  Miroshnichenko .
11 reviews1 follower
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.
Profile Image for Lisa Hunt.
533 reviews11 followers
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.
Profile Image for Farrah.
935 reviews
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.
Profile Image for Kathryn Summers.
15 reviews3 followers
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.
Profile Image for Patricia Burgess.
Author 2 books6 followers
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.)
Profile Image for Angela Carlson.
122 reviews2 followers
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.
46 reviews
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.
Profile Image for Annetteaux.
32 reviews1 follower
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.
Profile Image for Marie (find me on StoryGraph).
197 reviews2 followers
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.
Profile Image for Amy.
4 reviews2 followers
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.
Profile Image for Diana Duell.
311 reviews5 followers
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.
Profile Image for Jane Bennington.
318 reviews3 followers
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.
Profile Image for Jess Dollar.
668 reviews22 followers
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.
Profile Image for Mckochan.
561 reviews2 followers
June 26, 2024
Worth reading for anyone whose doctor automatically says, 'You just have to live with menopause." Blah blah blah. No.
Profile Image for Lucas.
116 reviews
August 14, 2025
4/5

For a book whose title is all about the positive effect of hormones on women's health, the book feels just as committed to explaining this as it does to explaining the appregehensiveness behind HRT and the history behind this, and honestly, it does a good idea of it in my opinion.

The book really does show the fact that it's written by a psychologist in how it talks about the history of ERT and the backlash that it faced over mischaracterizations, faulty science, and poor/deliberately biased reporting. In this sense, I really feel like I gained a great understanding of the history of this therapy to a degree that this book was far more digestable.

When it came to the actual science of the drug, I found it to be a reasonable amount for somebody of my education and prior knowledge, which isn't significant. I found the fact that I could easily understand it to actually be something of a red flag if that makes any sense, as it felt overly simplified. There was a very clear confirmation bias and an eagerness to speak less about certain negative aspects of ERT. The book would spend page after page talking about how ERT can play a positive role in improving many ailments associating with post-menopause, but while the book acknowledges and doesn't downplay the severity of certain possible dangers such as blood clotting, it does skim past this very quickly, and acknowledge it as though it's a past concern, saying this risk was highest in certain types of estrogen no longer primarily used in the new treatments the book talks about. However, this gives a certain impression that it isn't a possible concern with estrogen even now, though it very much is.

For this reason, I think the book is good, but certainly isn't comprehensive on the subject, though I do certainly agree with most of what the book is getting at, and feel like for it, I have a far better understanding now of menopause and what treatment for it has looked like across time, the chemical nature of how it works the way it days, and medical means of approaching it.

Good book, but probably not one to be digested alone.
Profile Image for jammaster_mom.
1,057 reviews8 followers
October 2, 2023
This is an amazing book! I wish every woman could be gifted this when she turns 30!

This book is an excellent guide to the many studies that have been done over the years looking at hormone replacement therapy (HRT). The book looks at the different diseases and conditions that women face in middle-age and beyond. There is a chapter that addresses women who have had cancer and studies that have been done.

This book can be dry at times but it is chock full of information. Reading this book is a great way for women to learn what happens during peri-menopause, menopause, and post-menopause so that they can have a conversation with their health care provider. Most health care providers receive little to no menopause training or teaching.

There is so much that women are not taught and many of us have little to no family history to guide us. 100% of women who live long enough will go through menopause. We need to know the signs and symptoms of peri-menopause. We need to know about when to expect to see those symptoms and options of what to do. Educate yourself and be prepared to have important medical conversations. If your provider will not have a conversation, find a different provider! The Menopause Society of America has a provider search feature on their website.

HRT is not for every woman. Each woman needs to have an educated conversation with her provider to figure out the best options for her symptoms so that she can live a full life.
Profile Image for Javiera Ibarra.
143 reviews6 followers
April 4, 2025
Various things, to be completed.

Overall, the book dies a fantastic job at exposing the flaws of the Women's Health Intervention Study, revealing through scientific evidence how HRT, and estrogen in particular, is the most beneficial treatment for menopause, regardless of your symptoms. The loss of estrogen in the body, an occurrence

- The book says that exercise is not helpful at all for brain health... It repeats at least three times that there is no scientific evidence that shows that exercise can positively impact your brain or reduce your risk of dementia. This seems quite strange to me. I just read Dr. Mosconi's book "Brain Food" where the opposite is stated. Same thing goes for keeping active relationships with the people around you, being surrounded by friends and affection...

I understand that if I offer my own example of how exercise has improved my quality of life and therefore my life expectancy (giving me better sleep, protection against bone fractures, better hormonal synthesis, and bc of the later also better brain health), it's NOT scientific proof, and I understand that. However, exercise does affect many areas of life and the body that have been reported as benefiting the brain. Ultimately I understand what the book says, that in the end it's estrogen the major (the book says the only) factor that determines our risk of dementia, but at least personally I choose to view exercise as an essential ally that promotes multiple health benefits that (perhaps indirectly) benefit the brain and protect it against dementia.

- From this book, it is not clear whether the pill is a good option for HRT in perimenopause. The authors describe the pill as safe and beneficial (quoting several studies that show how it reduces the incidence of breast, colon and ovarian cancer in users). However, they don't specify if the pill should be taken for contraceptive use or if it can be a good option to treat perimenopausal symptoms WITHOUT interfering with other health issues or if it can be an equivalent or better alternative to HRT. The later is not the case in the book Hormone Repair Manual, also written by an MD.
Profile Image for Michelle Carlson.
85 reviews
January 20, 2025
This book provided a thorough look at hormone replacement therapy for women in perimenopause and beyond.

It especially focused on examining the alleged link between hrt and breast cancer. This concern stems from a study that was flawed in several ways, and alarmist reporting which make a big impact before the study results were even published. The book discusses this study and several others at LENGTH. It was a slog to get through it all because it felt like the authors made their point a long time ago but it kept bringing up more and more evidence and more studies proving that people on hrt actually have less instances of breast cancer, not more. I can say that it was both thorough and compelling.

It also covers how hrt has extensive health benefits beyond symptom relief. It reduces the risk of cardiovascular disease, stroke, cancers, osteoporosis, and dementia. It adds, on average, 3-4 years to a woman’s life.
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