Word: progestins
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...adding yet another chapter to the continuing (and confusing) story of hormone therapy (HT) taken during and after menopause. In the latest report, appearing in the Journal of the American Medical Association (JAMA), the study doctors report that the health risks of taking the combined hormones estrogen and progestin can linger for up to three years after women stop taking them...
...good news is that many of the other health risks associated with hormone therapy -heart disease and blood clotting, for example - did diminish rapidly once the hormones were stopped. Less welcome is the fact that any benefits derived from estrogen and progestin in keeping bones strong also dissipated soon after the women terminated their hormone therapy...
...While the fact that HT's risks may last longer than any woman would like, doctors stress that this risk is still very small. The overall risk of cancer, for instance, among women taking estrogen and progestin, comes to three extra cases per 1000 women per year. For breast cancer, the study found one extra case per 1000 women per year. "It's helpful to translate the findings into absolute cases," notes Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital. "So for women who are having distressing menopausal symptoms, who are not sleeping...
...Manson also notes that at the time the study was being conducted, between 1993 and 1998, the estrogen and progestin preparations were not available in the lower doses that are used today, and that most women had been taking the hormones for longer than the one to two years that current guidelines recommend. (Researchers are planning to study the long-term risk-benefit profile of lower dose formulations and shorter exposure periods...
...link between protective mental health benefits and estrogen therapy appears to conflict with the findings of the Women's Health Initiative (WHI), which found that women who took estrogen alone or estrogen plus progestin from age 65 increased their risk of mild impairment or dementia - along with other cardiovascular problems. But the authors of the Neurology studies stress that the age-dependent window is key when considering therapy and mental health. "Below 50, estrogen is protective. After 65 it is harmful. But nobody really knows between 50 and 65," says Rocca. "In the middle it's still unclear...