Word: estrogen
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While gynecologists acknowledge that there are risks to estrogen therapy, they tend to emphasize the pluses. "The benefits of HRT will outweigh the risks for most women," says Dr. William Andrews, former president of the American College of Obstetrics and Gynecology. "Eight times as many women die of heart attacks as die of breast cancer...
Still, the specter of cancer continues to haunt HRT. With last week's New England Journal report, hope faded that progestin would offer estrogen users protection against breast cancer, as it does against uterine cancer. In fact, it appears that the combined hormones may put women at a higher risk for breast cancer than estrogen alone. This bad news came in the wake of an alarming report in May suggesting that long-term use of estrogen heightens the risk of fatal ovarian cancer...
Even before these disturbing reports appeared, American women were distinctly less exuberant about estrogen than their doctors. A 1987 survey showed that 20% of women given a prescription for estrogen never even fill it. Of those who do begin taking the hormone, a third stop within nine months, and more than half quit within one year. Many others go on and off HRT. Some do it because they don't feel quite right on the medication, some because they hate taking drugs, many because they worry about cancer. "I feel like a guinea pig," complains a 52-year-old woman...
Breast-cancer specialist Dr. Susan Love shares her skepticism: "Many gynecologists are handing out these hormones like M&M's," she says. No matter how beneficial estrogen may seem, no drug treatment comes without drawbacks. In biology as in business, notes the Los Angeles oncologist, "there's no free lunch...
...understand the risks and wonders of estrogen therapy, it helps to know something about the hormone's natural role in the body. Estrogen is powerful stuff. Receptors for the hormone are found in some 300 different tissues, from brain to bone to liver. This means that in one way or another, all these tissues respond to the presence of estrogen. Some, including tissues in the urinogenital tract, the blood vessels, the skin and the breasts, require estrogen to maintain their tone and flexibility...