Are you avoiding estrogen because you’re confused or think it’s unsafe? It’s understandable. Millions of women are.
But a new analysis of earlier, negative reports and several new ones now clearly show that women who begin taking estrogen containing hormones at or near the beginning of menopause live longer and have less chronic diseases such as breast cancer, heart disease and many more.
They also have a better quality of life and perform better at work.
Simply stated, estrogen has been proven both safe and beneficial for most women. Here’s how I came to that conclusion.
In the late 1990s, estrogen was the most prescribed medicine in the United States. Estrogen was and is the most effective treatment of menopause symptoms like hot flashes, brain fog and poor sleep, and according to observational studies — meaning studies without a placebo control group — estrogen appears to lower the risk of heart disease, osteoporosis, dementia and the overall likelihood of dying.
All that changed in 2002 when a study called the Women’s Health Initiative (WHI) reported that the oral estrogen Premarin, combined with a synthetic progesterone called Provera (PremPro), caused an increased risk of breast cancer, heart disease and possibly dementia.
Provera is very different from progesterone and has more negative side effects. The women in that study had to take a combination of estrogen plus progesterone or a similar medicine because women who have a uterus, i.e., not had a hysterectomy, must take both medications to prevent estrogen alone from causing uterine cancer.
When both hormones are used, uterine cancer is prevented. Women who have had a hysterectomy need estrogen only.
As I explain in my book, “The Estrogen Window,” the women in the 2002 WHI study who received the PremPro were largely ages 60 to 79 and many were smokers, had diabetes and high blood pressure.
The women who received the placebo were mostly ages 50 to 59 and healthy. Not surprisingly, the older women with health risks who took the PremPro had more bad outcomes.
In 2013, the original data from both the 2002 WHI study, and a 2004 study that compared women who took estrogen only with women taking a placebo, was reanalyzed. But this time, both the placebo group and the women who took either estrogen alone or estrogen plus Provera were between the ages of 50 to 59, or within 10 years of the beginning of menopause.
The results were very different!
Women who began their hormones close to the time of menopause had a decreased risk of heart disease and an overall lower risk of dying than those who took the placebo.
They also didn’t have the perceived increased risks of breast cancer. In fact, women who took estrogen only had a lower risk of breast cancer. Those who took PremPro had a minimal increased risk of one breast cancer case per 1,000 women who took it, which is a lower breast cancer risk than women who have an increased breast density, increased waist/hip ratio and have their first child after age 35.
Women who took an estrogen containing medication were also at a lower risk of developing Type 2 diabetes than those who didn’t. According to the US National Safety Council, the annual risk of death in a motor vehicle is 1/6500; death from walking across the street 1/48,500, and getting murdered 1/10,000 to 1/16,500.
Studies from other countries have also found estrogen beneficial if begun near the time of menopause.
A nationwide study from Finland evaluated over 500,000 women taking hormones and found that starting them close to the time of menopause significantly lowered the risk of stroke, heart disease and all causes of dying.
Similarly positive results were found in a large controlled study from Denmark. Other studies have found that estrogen lowers the risk of depression, chest pain and Parkinson’s disease.
Besides enduring the symptoms of menopause or struggling to identify estrogen alternatives, there are some other very important consequences of estrogen avoidance.
In one study of over 500,000 women with hot flashes, half of whom were receiving treatment, the 250,000 women not treating their hot flashes made 1.5 million more visits to the doctor over a 12-month period than those who were treating their hot flashes. The additional health care cost approximately $340 million. This also reduced work performance and increased absenteeism.
While a holistic approach can support women whether or not they choose to take estrogen, before you decide to tough it out I encourage you to figure it out. It’s the most important midlife decision you will make.
Dr. Mache Seibel (Dr.Mache.com) one of America’s leading experts on women’s wellness and menopause, is author of “The Estrogen Window” and editor of The Hot Years – My Menopause Magazine.
[The content provided through this article and www.nydailynews.com should be used for informational purposes only and is not intended to be a substitute for professional advice. Always seek the advice of a relevant professional with any questions about any health decision you are seeking to make.]
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