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Hello there. Jeez, you all are making me work this week. I could write a book on this topic! Where should I start?

As a long-standing member of the British Menopause Society, I have extensively reviewed the literature from the 2001 Women's Health Initiative (WHI) study conducted in the United States, which involved around 50,000 postmenopausal women. The study aimed to identify why there was an increased risk of breast cancer among patients on hormone replacement therapy (HRT) at the time. Upon reviewing the study, it becomes clear that the increased breast cancer risk was associated with synthetic progestins, which were commonly prescribed then. Conversely, there did not appear to be a significant increased risk with monotherapy on synthetic estrogen preparations like Premarin. Many individuals, including esteemed clinical colleagues, often confuse body-identical progesterone with synthetic progestins, which can be misleading for patients.

While there are inherent risks with any medication, it is crucial to remind ourselves and our patients that quality of life is paramount. As we age, the likelihood of diseases such as cancer, heart disease, and diabetes increases due to the declining efficiency of our cellular functions and changes in our molecular biology.

Throughout my many years treating menopausal women, I have found that body-identical progesterone significantly improves mood and sleep. Consequently, it made perfect sense to prescribe body-identical progesterone for my transgender female patients, as it is a female hormone. Unfortunately, many consultants and endocrinologists view progesterone solely as a hormone that supports pregnancy or maintains the uterus in long-term HRT. However, since I began prescribing body-identical progesterone, specifically Utrogestan, for transgender female patients in 2017, we have observed numerous positive effects. These include improved mood, better sleep, and the development of glandular breast tissue, to name but a few.

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