Estrogen Controversy

THE EVOLVING HISTORY OF ESTROGEN REPLACEMENT

Last Updated:Spring 2014

During our years of medical practice, the pendulum of the estrogen replacement controversy has swung back and forth several times.

For many years, the standard of care was hormone replacement in all perimenopausal and postmenopausal women for the rest of their lives.

However, in July 2002 the National Heart, Lung and Blood Institute, a division of the National Institutes of Health (NIH), released the results of their long-term study which concluded that for every 10,000 women taking Premarin, Provera, or Prempro, there was a marginally increased risk of heart attack, stroke, blood clots, and breast cancer, especially in older patients.

In the Spring of 2003 the New England Journal of Medicine reported the results of the Women’s Health Initiative (WHI), a study conducted on 16,000 women ages 50-79 to determine if HRT had any effect on a variety of postmenopausal “quality of life” issues such as depression, cognitive function, sleep, and sexual satisfaction. There was no significant difference in these particular “quality of life” issues between the ladies taking HRT and those taking only a placebo. It should be noted that most of these women were far past menopause.

Then, on 2/14/06…

The latest studies are showing that hormone therapy (HT), if used during the peri-menopausal years only (in women under age 60), reduces risk of osteoporosis, hot flashes, night sweats, mood instability, coronary heart disease, and total mortality. Risks of HT include slightly increased risk of venous clotting, stroke, and breast cancer. (Journal of Menopause, 2012)

So what now for you? Should you take estrogen? Should you take estrogen with progesterone? What about “bio-identicals”?  (A little known fact is that many prescription hormones are already “bio-identical”.)

The answer is to schedule an office visit with us to discuss the risks and benefits of the many therapeutic options, so we can help you make a confident, informed decision.