July 13, 2002 was a time of confusion and misunderstanding concerning the article published in JAMA, July 13, 2002, concerning the use of synthetic estrogen and progestin.  The Women’s Health Initiative Study revealed that the combination of synthetic hormones, Premarin and Provera or PremPro, resulted in an increase risk of breast cancer and heart disease.  As a resident during this time, I saw many women go through withdrawal menopause and a drop in their quality of life.  Experts from all fields of medicine have called for a discontinuation of all hormone replacement as there have been ample evidence to implicate an increased risk of breast cancer and heart disease with the use of synthetic hormones.  Many physicians claim that hormones make no difference.  This is incorrect.  The natural estradiol and progesterone are potentially protective and when weighing benefits and risks, should be a part of the armamentarium to combat osteoporosis, cancer, dementia and heart disease.  The health deterioration starts at menopause or andropause when our hormones decline–bone loss, risk of heart disease, loss of libido, depression, urogenital atrophy and cerebral deterioration.  There is a wealth of literature regarding the benefits of bioidentical hormones which are identical biochemically to what is in your body.