Should More Women Be Taking Estrogen Recent Data Says Yes
Hormone Replacement Therapy.
Until about 20 years ago, physicians routinely prescribed the hormones estrogen and progestin for women after menopause, when levels of both of these hormones decline. This seemed like a logical treatment, and the hope was that it would slow down bone loss , reduce the risk of heart disease, and treat other age-related problems. Estrogen also has the benefit of increasing sexual desire for women.
This all came to a screeching halt in 2002, when the Womens Health Initiative published its first findings about the effect of estrogen and progestin. Although the initial results did show benefits for osteoporosis, the main finding, trumpeted loudly at the time by NIH and in various press releases, was that the combination therapy increased the risk of breast cancer. As the US Office on Womens Health says today on their website, the 2002 study found that women taking combination hormone therapy for menopause symptoms had an increased risk for breast cancer, heart disease, stroke, blood clots, and urinary incontinence. Although women using combined hormone therapy had a lower risk of fractures and colorectal cancer, these benefits did not outweigh the risks.
It turns out that this was not the full story.
Not surprisingly, the use of hormone replacement therapy plummeted after that, and has remained low since.
The Womens Health Initiative
This study is part of the very large Womens Health Initiative Clinical Trial and the Womens Health Initiative Observational Study. Both studies are commonly called the WHI. Together, the two studies include information from more than 161,608 postmenopausal women who were ages 50 to 79 when they joined between 1993 to 1998. The WHI wants to find any links between health, diet, and lifestyle factors and health problems such as cancer.
A Change In Recommendations
These studies were the first large-scale trials that looked for cause and effect with heart disease and HRT. HRT does offer some benefits, such as preventing osteoporosis and reducing the risk of colon cancer. But the data on heart-related risks from these studies were very compelling. As a result, the American Heart Association and the U.S. Food and Drug Administration developed new guidelines for the use of HRT:
The bottom line, say physicians at the Miller Family Heart, Vascular & Thoracic Institute at Cleveland Clinic: weigh the benefits of HRT against the risks and discuss the whole subject of HRT with your physician to be able to make an informed decision.
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What Are The Risks Of Hrt
The health risks of HRT include:
- Increased risk of endometrial cancer For women who have had a hysterectomy , this is not a problem
- Increased risk of breast cancer with long-term use
- Increased risk of cardiovascular disease
- Increase in inflammatory markers
- Increased risk of blood clots and stroke, especially during the first year of use in susceptible women
All women taking hormone replacement therapy should have regular gynecological exams . The American Cancer Society also recommends that women over age 50 should:
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The body has an amazing ability to heal. We just need to give it the right resources.
In Overcoming Estrogen Dominance, my goal is to empower and give you the tools to take control of your hormones and health.
More than 70% of women experience estrogen dominance. The symptoms range from lumpy and fibrocystic breasts to thyroid nodules, hot flashes, fibroids, uterine polyps, painful, heavy or irregular periods to infertility and miscarriages, from mood swings to insomnia, weight gain to fatigue.
So many women have experienced the pain and frustration that comes when they feel their symptoms and complaints are dismissed or minimized. This is particularly true for women who are experiencing the symptoms of hormone imbalance. Even when doctors do offer treatment, its typically in the form of prescription medication or invasive surgical procedures.
In Overcoming Estrogen Dominance, I hope to show that those extreme interventions are often unnecessary, and to give women a roadmap to reverse estrogen dominance using food, herbs, supplements and natural protocols to rebalance hormones.
To get your copy of Overcoming Estrogen Dominance, go here.
Disclaimer
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
What Is Known About Hormone Therapy And The Risk Of Heart Disease
Scientists continue to learn about the effects of HT on the heart and blood vessels. Many large clinical trials have attempted to answer questions about HT and heart disease. Some have shown positive effects in women who started HT within 10 years of menopause; some have shown negative effects when started greater than 10 years of menopause. Some studies have raised more questions about the potential benefits of HT.
Based on the data, the American Heart Association issued a statement for use of HT. They say:
- Hormone therapy for the sole purpose of preventing heart disease is not recommended.
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Womens Health Initiative Studies Of Hormone Therapy And Cancer Risk
Several large studies have looked at possible links between systemic hormone therapy in menopausal women and different types of cancer.
The main randomized studies of MHT were part of the Womens Health Initiative . The WHI included 2 randomized placebo-controlled clinical trials of MHT in healthy women:
- One study looked at estrogen therapy in post-menopausal women who didnt have a uterus. Over 5,000 women in the ET group took a daily dose of estrogen in the form of conjugated equine estrogen for an average of about 6 years. The researchers then continued to follow them for several years to look for any further effects of the hormone. The women were compared to more than 5,000 in the placebo group.
- The other study looked at estrogen-progestin therapy in post-menopausal women who still had their uterus. Over 8,500 women in the EPT group took a daily dose of CEE plus a progestin called;medroxyprogesterone acetate;for an average of about 5 years. This group was compared to a group of more than 8,000 women in the placebo group.
The WHI also conducted some observational studies. However, when we mention a WHI study below, were referring to one of the randomized studies.
The Function Of Estrogen
Estrogen is the hormone that is primarily responsible for the sexual development in girls as they reach puberty age.;Other functions of estrogen include:
- initiates;changes in breast tissue during adolescence and pregnancy
- helps;to regulate menstrual cycles;;
- regulates;bodyweight by helping to control metabolism;involved;in the development and growth of healthy bone tissue
- may;play a role in promoting;healthy cardiovascular; activity, according to the;American Heart Association
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Reducing The Cancer Risks Of Hormone Therapy
If you and your doctor decide that MHT is the best way to treat symptoms or problems caused by menopause, keep in mind that it is medicine and like any other medicine its best to use it at the lowest dose needed for as short a time as possible. And just as you would if you were taking another type of medicine, you need to see your doctor regularly. Your doctor can see how well the treatment is working, monitor you for side effects, and let you know what other treatments are available for your symptoms.
All women should report any vaginal bleeding that happens after menopause to their doctors right away it may be a symptom of endometrial cancer. A woman who takes EPT does not have a higher risk of endometrial cancer, but she can still get it.
Women using vaginal cream, rings, or tablets containing only estrogen should talk to their doctors about follow-up and the possible need for progestin treatment.
For women who have had a hysterectomy , a progestin does not need to be a part of hormone therapy because theres no risk of endometrial cancer. Adding a progestin does raise the risk of breast cancer, so ET is a better option for women without a uterus.
Women should follow the American Cancer Society guidelines for cancer early detection, especially those for breast cancer. These guidelines can be found in;Breast Cancer Early Detection.
Do Alternative Remedies Help With Menopause Symptoms
Studies into natural treatments for menopause symptoms have had mixed results. Some have shown that soy helps with hot flashes and night sweats but might be dangerous for women at risk for hormone-related cancers of the breast, ovaries and uterus. Black cohosh may help some women control hot flashes, night sweats, mood swings, and insomnia — but again, research has been mixed, and some reports have linked black cohosh to liver problems.
Other natural remedies include chasteberry, red clover, dong quai, kava, and evening primrose oil. Your doctor can help you decide whether any alternative treatments are right for you.
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Common Causes Of Excess Estrogen
There are a few different causes of excess estrogen production. Many of them all involve a certain enzyme called aromatase.
This enzyme has the ability to convert excess testosterone into estradiol and androstenedione into estrone.
Both estradiol and estrone are estrogen hormones which can be found in men. Basically, aromatase enzymes take away lots of testosterone and convert it into estrogen.
Excess aromatase enzymes can be caused by a rare genetic disorder called aromatase excess syndrome . This can lead to short height, gynecomastia, and a more feminine appearance.
They can also be caused by diet, where certain foods such as soy can increase aromatase.
Increased cortisol can increase aromatase, as can alcohol. High levels of alcohol can massively increase aromatase. This is why alcoholics tend to have a lack of muscle mass and the development of breasts .
Increased body fat levels can massively increase aromatase, as the enzyme can be produced in adipose tissue.
This often creates a vicious cycle as increased estrogen can further increase body fat! Even the environment can cause increased aromatase. With certain chemicals able to increase aromatase production.
One cause that is common in bodybuilders is testosterone replacement therapy. Where anabolic androgenic steroids are taken to increase testosterone in the body.
This is fine while youre taking the steroids, but you can only do so for about 12 weeks at a time. Afterwards, you need to have a 3-4 week break.
What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. You should have a complete physical exam, including blood pressure measurements, breast and pelvic exams, and a Pap test at least yearly. Follow your doctor’s directions for examining your breasts; report any lumps immediately.
If you are taking hormone replacement therapy to treat symptoms of menopause, your doctor will check every 3 to 6 months to see if you still need this medication. If you are taking this medication to prevent thinning of the bones , you will take it for a longer period of time.
Before you have any laboratory tests, tell the laboratory personnel that you take hormone replacement therapy, because this medication may interfere with some laboratory tests.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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Please Answer Yes Or No To The Following Questions:
1. Do you have abnormal vaginal bleeding, such as extremely heavy periods or spotting between periods?
Yes No
2. Is there a history of breast cancer in your family?
Yes No
3. Do you have a history of endometrial or uterine cancer?
Yes No
4. Do you currently have, or have you in the past had, venous thrombosis ? This includes thrombosis or blood clots during pregnancy or when taking birth control pills.
Yes No
5. Do you have chronic liver disease?
Yes No
Estrogen Treatment: Topical Creams Gels And Sprays
- What are they? Estrogen gels , creams , and sprays offer another way of getting estrogen into your system. As with patches, this type of estrogen treatment is absorbed through the skin directly into the bloodstream. The specifics on how to apply these creams vary, although they’re usually used once a day. Estrogel is applied on one arm, from the wrist to the shoulder. Estrasorb is applied to the legs. Evamist is applied to the arm.
- Pros. Because estrogen creams are absorbed through the skin and go directly into the bloodstream, they’re safer than oral estrogen for people who have liver and cholesterol problems.
- Cons. Estrogen gels, creams, and sprays have not been well-studied. While they could be safer than oral estrogen, experts aren’t sure. So assume that they pose the same slight risk of serious conditions, like cancer and stroke.One potential problem with using this type of estrogen treatment is that the gel, cream or spray can rub or wash off before it’s been fully absorbed. Make sure you let the topical dry before you put on clothes. Always apply it after you bathe or shower.
Because the estrogen is absorbed right through the skin, don’t let other people in your family touch these creams or gels. If they do, they could get dosed with estrogen themselves. For the same reason, make sure your hands are clean and dry after applying the medication.
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What Are Side Effects Associated With Using Estradiol
Side effects associated with use of Estradiol, include the following:
- Freckles or darkening of facial skin
- Changes in menstrual periods
- Skin irritation and redness at application site
- Spotting
- Vaginal discomfort, vaginal erosion, vaginal ulceration, adherence of the vaginal ring to the vaginal wall
- Vomiting
- Weight changes
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
Is Hrt The Same As Birth Control
No. Although women who take birth control pills are also taking estrogen and progestin, the effect is not the same. Women who take birth control pills have not been through menopause and need higher levels of hormones to prevent ovulation. HRT is not a high enough strength to stop ovulation.
After menopause, estrogen levels are low and HRT is used at a low dose to restore hormone levels to a more normal level.
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Post Menopausal Hormon Replacement Therapy
How prevalent is heart disease among women?
Female Reproductive Organs
Cardiovascular disease is NOT just a mans disease. Cardiovascular disease is the Number 1 killer of women over age 25 in the United States, regardless of race or ethnicity. Once a woman reaches the age of 50 , the risk for heart disease increases. In young women who have undergone early or surgical menopause, the risk for heart disease is also higher, especially when combined with other risk factors such as:
- Diabetes
- Elevated LDL cholesterol
- Low HDL cholesterol, sometimes called “good” cholesterol
- Obesity
- Family history of heart disease
What is menopause?
Menopause is a normal stage in a womans life. The term menopause is commonly used to describe any of the changes a woman experiences either before or after she stops menstruating. As menopause nears, the ovaries gradually produce less estrogen , causing changes in the menstrual cycle and other physical changes. The most common symptoms of menopause are hot flashes, night sweats, emotional changes and changes in the vagina .
Technically, menopause is the end of a womans reproductive cycle, when the ovaries no longer produce eggs and she has her last menstrual cycle. The diagnosis of menopause is not confirmed until a woman has not had her period for six to twelve consecutive months.
How is heart disease associated with menopause?
What can be done to reduce the risk of heart disease for menopausal women?