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Menopause & Estrogen After The Women’s Health Initiative

Menopause & Estrogen After The Women’s Health Initiative

Millions of women in menopause are afraid to take estrogen and struggle to deal with their symptoms. But for many, that isn’t necessary. In the 10 years since one of the most significant papers in women’s health was published – a study on the risks and benefits of estrogen plus progestin in healthy postmenopausal women – many of the original conclusions that scared the hell out of women and many of their doctors (see below) have been disproved.  But harm was done for women; fear prevented many women from taking estrogen that could have prevented terrible symptoms, and those women suffered. I want to help you make sense of these important studies.

First, let’s look at what the two studies were supposed to do.

At that time, estrogen plus progestin (notice, not progesterone which is the natural hormone, but progestin, a synthetic substance that the woman’s body responds to similarly to how it responds to progesterone) were being recommended for all women in menopause to lower the risk of heart disease as well as treat symptoms of menopause such as hot flashes and vaginal dryness. Postmenopausal women ages 50 to 79 (mean age 63) were given different formulations of the most common estrogen and progestin medications in use at the time.

Giving hormones to older women, they thought, would lower their risk of heart disease and so the study didn’t take into account how old the women were, how long it had been since they started going through menopause, or if they were at risk for any other diseases. Hormone Therapy (HT) was considered both good and safe.

There were two hormone studies that were started about the same time. The first involved giving some 16,000 women either estrogen and progestin (Prempro – the most commonly used hormone of this type at the time) or placebo. That study was stopped 3 years early because the risks were greater than the benefits.  Not only did HT not protect women from heart disease, the study reported an increased risk of blood clots, stroke, heart attack and breast cancer. There was however, an equally lower risk of colon cancer and risk of breaking your hip.

The second study also followed a large number of women. But this group of women had their uterus removed (hysterectomy), as well as their ovaries. Women who have their uterus removed do not need to take progesterone or progestin – only estrogen. Once again, the study was stopped early because the women taking estrogen had an increased risk of stroke compared to those who took a placebo. However, compared to the women in the first study who took estrogen and progestin, these women who took estrogen only didn’t have an increase of breast cancer or heart disease.

Postmenopausal women threw away their estrogen in droves and endured a very challenging window of time. So challenging in fact that many of my patients who initially went off their hormones called me up and within 3 to 6 months, wanted to get back on them. But in that year after the WHI was first published, between 25% and 72% of women stopped taking HT.

Over the past decade since those initial WHI studies were done, many of their conclusions have changed. Here are my thoughts on the highlights and where we are today.

If you are interested in taking estrogen and/or progesterone or want to consider it as a possible treatment for your symptoms, talk with someone who is knowledgeable about these medications. It isn’t the same as going in for an antibiotic – it will take time for the health professional to understand your personal risks, explain what the benefits and risks are for you, and provide you with an explanation of your options. When I see patients for these types of discussions, I allot nearly an hour to go over everything. Make sure you find the right person to work with you.

To help you prepare, CLICK HERE for a FREE EBOOK on How To Take Estrogen.


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Read more: Aging, General Health, Health, Healthy Aging, Menopause, Osteoporosis, Stay Well With Dr. Seibel, Women's Health, , , , , ,

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Dr. Mache Seibel

Women's health expert and guest speaker Dr. Mache Seibel addresses consumers' critical needs from weight control to HRTmenopause and beyond. He served on the Harvard Medical School faculty for 19 years and is founder of My Menopause Magazine on the Apple Newsstand ( Download the Free App and first Free issue. He works with companies and organizations to bring exciting educational content to consumers. Visit his award-winning website to sign up for his free monthly newsletter.


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4:56AM PDT on Aug 12, 2012

There needs to be more research in this area to empower women to make informed decisions.

4:18PM PDT on Jun 29, 2012


12:58PM PDT on Jun 26, 2012

Thanks. . . I will take note of all comments when it comes to my time. . .of the wonderful, dreaded, menopause.

12:13AM PDT on Jun 26, 2012

Interesting, thank you.

9:31PM PDT on Jun 25, 2012

I have taken estrogen now for over six years using the lightest dose and through a patch. I feel wonderful after some horrible symptoms of menopause; I am back to my ordinary self. I do watch what I eat no saturated fat or butter just olive oil. No red meat and I monitor my blood pressure which is at a normal rate. I am over fifty and I hope to take it the rest of my life.

11:43AM PDT on Jun 25, 2012


10:23AM PDT on Jun 25, 2012

Stick to natural help, and avoid hormone treatment if possible. I regret taking it, as I developed breast cancer last year. Fortunately it was caught early on, and I have made a.good recovery. I feel very blessed.
Please avoid using creams, lotions , shampoos, toothpaste, make-up,etc with PARABENS in them. These chemicals mimic oestrogen, and are possible causes of breast cancer. Check products before you buy them, please. I feel I want to warn everyone about the risk.

10:05AM PDT on Jun 25, 2012


6:30AM PDT on Jun 25, 2012


3:50AM PDT on Jun 25, 2012

thank you

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

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