Word: progestin
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Today estrogen in its various forms -- pills, patches and creams -- is flowing as never before. Cancer risks have been diminished, doctors believe, by lowering the dosages used in hormone-replacement therapy (HRT). The risk of uterine cancer, in particular, can be virtually eliminated, experts say, by adding synthetic progesterone (progestin) to the estrogen prescription, either combined in one capsule or as a separate pill. Meanwhile a raft of studies showing new and unexpected benefits has propelled medical enthusiasm for the treatment to huge, if not quite Wilsonian, proportions. Estrogen, it seems, can prevent or slow many of the ravages...
Still, the specter of cancer continues to haunt HRT. With last week's New England Journal report, hope faded that progestin would offer estrogen users protection against breast cancer, as it does against uterine cancer. In fact, it appears that the combined hormones may put women at a higher risk for breast cancer than estrogen alone. This bad news came in the wake of an alarming report in May suggesting that long-term use of estrogen heightens the risk of fatal ovarian cancer...
Progesterone pills can be particularly hard to tolerate. Progestin is always prescribed along with estrogen for women with an intact uterus. While estrogen prompts the uterine lining to thicken, progestin signals it to stop growing and slough off; this artificial menstrual cycle seems to prevent endometrial cancer. But progestin often causes cramps, irritability and other PMS-like problems. In her 1991 book on menopause, The Silent Passage, Gail Sheehy tells how estrogen highs and progestin lows made her feel as though her body was "at war with itself for half of every month...
Norplant consists of six matchstick-sized capsules that, when inserted under the skin of a woman's arm between her armpit and her elbow, begin releasing small amounts of progestin, a hormone that blocks ovulation. The implant is effective within 24 hours of insertion for a period of five years with a success rate of 99.8%. Norplant is also cheap at about $500 for the capsules, insertion, and removal. By comparison, purchasing birth control pills over the same period would cost $900. Once Norplant is removed, fertility is restored. Not even stitches are necessary...
...postmenopausal women. The study will explore the effects of diet, smoking and other factors on women's risk of developing heart disease, stroke, osteoporosis, and breast and colon cancers. The study will also evaluate the effects of hormone replacement therapy: providing women with supplemental estrogen or with estrogen plus progestin after menopause...