Word: progestin
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When is it a good time to take estrogen? Every new study on hormone replacement therapy and menopause seems to confuse the question further. Taking estrogen and progestin has been linked to increased risks of heart disease, stroke and even breast cancer in postmenopausal women. But what about taking estrogen alone, for women who have had their uterus or ovaries removed? Studies have suggested that there's a critical, age-dependent window before menopause during which the hormone - either the body's natural estrogen or that which is introduced during therapy - is protective. Now, two new, related studies...
...largest and longest-running survey of the effects of hormone therapy in post-menopausal women. It was the WHI, back in 2002, that turned everything that doctors and patients had believed about the benefits of hormone therapy on its head. The federally funded trial revealed that estrogen and progestin after menopause did not protect women against heart disease, as doctors had previously thought, but in fact increased their risk of heart attack, stroke and breast cancer. After years of recommending the therapy for women well past menopause, doctors then pulled back, prescribing it only for women having the hardest time...
...found that younger post-menopausal women actually enjoyed a lower risk of adverse health effects from hormone therapy than their older counterparts. The new NEJM study specifically reports that women between the ages of 50 and 59 who have had hysterectomies and therefore used estrogen alone (not the estrogen-progestin combination) showed less calcium-based plaque - up to 40% less - in their heart arteries than those on placebo. That's great news for the millions of women struggling with the disruptive symptoms of menopause, but who have been too afraid of the health risks to start hormone therapy. In some...
...worth the slightly increased risk of these conditions, provided that they don't stay on the hormones for more than five years or so. Last April, another study from the WHI supported just this sort of judicious use. That study found that women who began estrogen and progestin, the most commonly prescribed combination (progestinis added to protect against uterine cancer; women with hysterectomies do not need progestin, since they have had their uterus removed), within 10 years of hitting menopause experienced less heart disease than their counterparts who began years after the Change...
...some doctors believe, there may be a window of opportunity where hormone therapy should be started. The whole idea behind estrogen and progestin therapy after menopause is for the supplemental hormones to replace the estrogen that the woman's body is no longer making. If hormone therapy starts while the naturally circulating estrogen is still around, some doctors think that the hormones will continue to exert beneficial effects on the heart. The latest study seems to support this idea...