Wednesday, April 04, 2007
Yet another finding on hormones
Hormone replacement therapy is back in the news, again. As we were discussing this around the CNN offices, I was surprised at just how many women weighed in. Many were so frightened about the risks including heart disease and breast cancer that they swore off hormone replacement altogether. Other women say they will continue to take their hormones regardless of the risks. Yes, they tell me, their symptoms of hot flashes and night sweats are that bad.

Well, today there was a new wrinkle in the whole debate. It is likely some good news. Turns out that after looking at all the studies on women and HRT, something very interesting emerged. For women between the ages of 50 and 60 - usually the beginning of menopause - there seems to be no increased risk of heart disease after all. The risk certainly goes up at age 60 and even higher at 70. (Full Story)

Remember, HRT seemed like a good idea when it was first introduced. As a woman's hormone levels go down over time, you could simply replace that with a pill. As a result, the hope was that you could fend off the ravages of time. Problem was, it didn't work. In fact, for many women the opposite was true. The rates of heart disease and cancer actually went up.

In some ways, the new finding doesn't surprise me. The current guidelines are, only if you have debilitating symptoms of menopause, take the lowest HRT dose possible for the shortest amount of time. Still, we are all different and our needs change over time. The women who are in that critical perimenopausal time frame have a new decision to make. In light of today's new information, should they take hormones to address the symptoms of menopause? Would you, if you were in that position?
I think it is up to the individual. My mother chose not to have hormone therapy, where my mother-in-law did have it. I guess menopause is different for each person. If it brings relief in the short term, I don't see anything wrong with it.
I would definitely continue with HRT. The hot flashes are near disabling, & having to have 3 sets of clothing at the office becomes overwhelming. Having HUGE cleaning bills is overwhelming. Never being able to wear silk (soak right through it!) or wool (too darned hot!)are overwhelming. Having to have the temperature be in the low 60s to be comfortable? Inconvenient to everyone in my family. The 'Swiss-cheese' memory and emotional instability affect every part of my life. No thanks!

Quality of life means more than longevity - although, every hot flash seems like it lasts a century...
Hi Dr. Gupta,
I'd first want to know if the drug companies are behind these new studies. If they are I'd run not walk away from these findings. Take Care
Dear Dr. Gupta, I am a 60-year old Caucasian woman from New England. I have a family history of cancer, including breast cancer and also heart disease. I refused to take HRT at the age of 36 after a partial hysterectomy. 40 years ago my first gynecologist (Mabelle Hiscock, Boston) said, " Do not use hormone creams, take hormone pills, limit red meats and do not eat skin from poultry. She know her stuff. I have not been so good about the red meat - I must do better on that score. So far, the disease has not caught up with me--I believe things would have been much different had I not known Dr. Hiscock. I enjoy your blog and advice.
Dearest Dr.Sanjay,
Being a 58 yr old menopausal woman,I am extremely interested on any solution,scientific research that may be discovered & successfully applied.
What seems to be severely neglected is studies on the triggers that cause hot flashes.
Personally,I experience hot flashes at the slightest mental discomfort. Eg. Whether I have enough change for the parking meter,to whether or not to make a minor or significant purchase. Any pressure applied from outside sources such as: "Why don't you volunteer?" or "Would you like another piece of chocolat cake?."
The emotional stresses triggering all & any "flash" should be documented through sampling & statistics.I beleive that could be quite pertinent in the remedy for the treatment.
Is there not one thesis apllicable to enlighten those of the female gender,in order to provide some physical & emotional comfort during the "golden years" ? As I have tried a few(4-5).for 2yr terms, that are generally recommended by the Medical reseachers,with very poor results.
As for your interest in this disabling but inescapable fact of life,I suffer from post traumatic
stress,so I would be at the far end of the chart.I have noticed that women who are financial & emotionally secure report less severe symptoms. Is there a scientific correlation,& why isn't it being made public knowledge.We do need your help.
Thank you,
I went into full menopause before I was 50. I am now 61 and still on HRT because my night sweats are so bad that I become sleep deprived. I have tried to get off of it several times but the night sweats always come back. My quality of life is more important right now than the possibility that something MIGHT happen in the future.
Just a warning that I had a minor stroke this Winter. My neurologist told me that it was in part caused by Premarin (estrogen), together with slightly elevated blood pressure and elevated cholesterol. The three together are not a good combination. I went off estrogen immediately and have noticed no differences at all. Just a warning...
How do you feel about HGH enhancers to stimulate the pit.gland for feeling better in replacement to Hormone therapy?and is there any one special formula over the counter to buy instead of injections which are out rageously priced?
Absolutely, I will take the risks!

I had ovarian cancer at age 34 and was not given HRT for years for this reason. My life became a nightmare of hot flashes,night sweats, and repeated bladder & urinary tract infections, painful sex, and depression which followed. The solution was so simple...Premarin. It changed my life!
I am 59 now,and will not give up my hormones without a fight! Last year, when my physcian said it was time to get off HRT, I refused;I choose quality of life over quantity. Incidentally,he said that I was the fourth woman to threaten to leave him that day because of this/

We all have to make our choice based on our own experinces. As for me, let them just try to pry the HRT out of my hands at age 99!
I have a severe. chronic depressive disorder. I am 56 years old and have been taking premarin for the last 7 years. My family phyician felt there was a link between the depression and hormone levels. I stopped taking the premarin one year ago due to warnings and health risks. Six months later I was hospitalized for severe depression and suicidal thoughts. This had been my first hospitalization for a depressive disorder.Upon my release my family physician placed me back on premarin and my psychiatrist has stressed the importance of remaining on the medication. How much of a connection is there between severe depression and the use of hormone therapy?
I don't think I know anybody on HRT... and again, I am not yet at the age I'm worrying about it. But I AM on birth control, in part to regulate my hormones (which can also be dangerous depending who you are, how you react, your existing health issues, etc - but I haven't had a single problem). From descriptions people give me of menopause, many of the symptoms seem very similar to what I go through during PMS, even now. Even down to the hot flashes (which are a real pain in an office when everyone else is cold - at least if it were cold flashes instead I could just bring a sweater!).

But whether or not I will choose to take hormones during menopause, I cannot yet say. I guess really it will depend on the severity. Some women experience it worse than others. I've even heard that in some cultures, it goes completely unnoticed. Now whether that's a social thing and they just "suffer through" or if there's something dietary that affects it, I don't know. One would think they'd take a greater look at the causes though. Because if it were JUST the hormones, I would think it'd be a problem no matter where you go.

Is there something we can eat or not eat that might be changing how we experience that stage of our lives? Is it related to our activity levels? The type of hormonal issues we had as teens or young adults? I haven't heard of any studies that look into those things.

But maybe I'll get lucky and won't have to worry about it. As a friend of mine who had just started menopause once joked, maybe since I get all the hot flashes, mood swings and the like now, they'll just stop when I get older instead of getting worse. Or maybe they'll stay the same and I just won't notice a difference.
I am 55 and in excellent health and with a 43 year old boyfriend. Because of debilitating menopause migraines which started at age 45, I have been taking Premarin 0.625 for 10 years. I had a total hysterectomy 4 years ago and have felt fantastic ever since...not even a cold. Just this past few months I have weaned myself to the lower Premarin 0.425 dosage out of concern for strokes. The headaches reappeared during the transition. If I could be assured of no headaches (which prevent me from working) I would quit HRT completely, but I have loved being on it.
I'm 49 and recently went off birth control pills. I have not experienced night sweats or horrible hot flashes. I get warm but no sweating and the heat quickly dissipates. My friends suffer horrible symtoms so I wonder if my lifestyle makes the difference. I'm at a good weight, exercise daily, don't smoke, eat right, enjoy my job and am pleasantly busy. But even if these factors made a difference, would women be willing to change habits to avoid HRT use?
I recently read in a Prevention magazine edited book that Soy (in any form: milk, powder, cheese, etc.), because of its natural plant estrogens is as effective as hormone therapy without all the side effects. Why is this not prescribed more frequently? Greed?
I knew 10 yrs. ago that HRT was causeing breast cancer, in many women. I refused this therapy on that theory. I was laughed at by my physician,family members,friends.So I weathered out menopause, and made it through without drugs of any kind. I think more women would too, if these "womans magazines" would stop telling women how rough menopause is,and what help to seek.Life is great now these 6 yrs. past menopause. Why would any woman take pills to stop a normal body Cycle (menopause)?
I am 35, at 30 I had a total hysterectomy and until a year ago I was petrified of HRT. Finally after suffering for so long, at my annual check-up, I talked to my Dr. about my symptoms.(And my basket ball belly) She suggested that I try HRT.

All I can say is WOW!! Within twenty minutes, while driving home I had a smile on my face from ear to ear! I was dancing to the music in my car - I can't describe the feeling of being alive. A year later and I still feel great, and my basket ball is all but gone. No Way - No How will I give this stuff up!

I'm using a prescription called Femring. It lasts for three months at time! No pills, no shots, nothing to remember.
this really proves thatt god really cares
I�m still in my mid 40's but because of hormonal imbalances since adolescence I've gone through menopause-like troubles. Had very irregular to no periods for many years. At 40 my periods returned on their own. I�m lucky they are light and short. A lot of the Meno-like symptoms have stopped but not after much pain with mood, migraines, low libido. In my mid to entering into late forties I definitely keep an ear open to all the news on HRT. I have a little more time to see where this new positive news on HRT goes. I've also been looking into info regarding the Bio-identical treatments. They seem a lil complicated and time consuming and maybe even expensive though. But I might try this first for a little while. But if what I have gone through, at an early age, is anything close to what menopause can do to wise, loving, nurturing women we should be very active in this issue and push the cause to the forefront and put it right up there on par with breast health issues. I personally would not be embarrased that im menopausal if im healthy, alive and happy. If I can beat it I would wear it on my sleeve for everyone to know it is possible to be fabulous at any age with the benefit of wisdom.
I am 53 and controling my meno. with black cohosa and soy and red clover. I will not take any hormone replacment products. I also control my menopause with my diet. So far so good.
I have been going through perimenopause for 6 years, hot flashes all day and all night then I had a complete and total hysterectomy 2 years ago. Well I tried all the HRT drugs,patches and such. Today I am 50 years old and have hot flashes 24/7, mood swings and don't take any HRT drugs, No Dr. seems to know why with no estrogen in my system or any way of producing any, why and how this strange malady continues. You just never know what , where, when and why, or how things go the way they go.
I've noticed a lot of comments about soy over hrt. I've read soy has been linked to breast cancer. My gyn nurse practitioner told me hrt's don't cause cancer, but can help it grow faster if it occurs. I've heard the same about soy. I had a total hysterectomy at 45, am now 56, and have severe menopausal symptoms without my premarin .625. It's not just the length of life, but the quality and there's no guarantee I'll live longer off the premarin, but I know I don't enjoy life without it, so I'm on it unless a problem comes up.
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