Word: estrogenic
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...Initiative (WHI), the largest and longest-running survey of the effects of hormone therapy in post-menopausal women. It was the WHI, back in 2002, that turned everything that doctors and patients had believed about the benefits of hormone therapy on its head. The federally funded trial revealed that estrogen and progestin after menopause did not protect women against heart disease, as doctors had previously thought, but in fact increased their risk of heart attack, stroke and breast cancer. After years of recommending the therapy for women well past menopause, doctors then pulled back, prescribing it only for women having...
...just experiencing menopause. And they found that younger post-menopausal women actually enjoyed a lower risk of adverse health effects from hormone therapy than their older counterparts. The new NEJM study specifically reports that women between the ages of 50 and 59 who have had hysterectomies and therefore used estrogen alone (not the estrogen-progestin combination) showed less calcium-based plaque - up to 40% less - in their heart arteries than those on placebo. That's great news for the millions of women struggling with the disruptive symptoms of menopause, but who have been too afraid of the health risks...
...study is not, however, a free pass for estrogen therapy in all post-menopausal women. "These findings provide reassurance to recently menopausal women who are considering estrogen therapy for treatment of menopausal symptoms, that estrogen is not likely to have an adverse effect on the heart," says Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital and an author of the study. "But it does not mean that women should begin taking estrogen for the express purpose of preventing cardiovascular events because there are other risks of hormone therapy...
...hormone therapy may be worth the slightly increased risk of these conditions, provided that they don't stay on the hormones for more than five years or so. Last April, another study from the WHI supported just this sort of judicious use. That study found that women who began estrogen and progestin, the most commonly prescribed combination (progestinis added to protect against uterine cancer; women with hysterectomies do not need progestin, since they have had their uterus removed), within 10 years of hitting menopause experienced less heart disease than their counterparts who began years after the Change...
...same, unfortunately, doesn't hold true for older women. Estrogen and progestin have a habit of aggravating the hard, artery-clogging plaques that develop naturally with age. On the basis of animal studies and other heart-disease trials in human patients, the authors suspect that hormone therapy encourages the clots that form around these plaques to rupture and cause heart attacks. Nonetheless, the latest study offers a backward sort of good news, suggesting that intense menopausal symptoms may be a kind of early warning system, since women who suffer the most also tend to harbor more risk factors for heart...