|ESTROGEN DEFICIENCY DISEASE:
April 8, 1997
in this forum:
Could severe reactions to birth control pills contraindicate Hormone Replacement Therapy later in life? How effective are "natural" hormones as an alternative to traditional medicines? Should women with a history of breast cancer avoid estrogen therapy? Are there studies looking at the relationship between menopause and lost time at work? Could women in their 80s and 90s risk overdosing their systems with by taking estrogen? Additional Comments
March 27, 1997:
Reversing a recent panel of medical experts, The American Cancer Society advises women in their 40's to receive annual mammograms.
January 24, 1997:
National medical experts meeting in Washington, D.C. say women in their 40's should decide for themselves whether to have annual mammograms.
A position paper on the pro's and con's of taking estrogen at the onset of menopause.
An extensive reading list on menopause.
Nancy Anderson, Wausau, WI asks:
What about women who may have a family history of cancer? Should they still take the "normal" estrogren replacement or wait and take one of the newly developed hormones that are not estrogen?
Do any of the herbal replacement therapies really work?
Dr. Susan Love responds:
I am wary about the use of hormone therapy for prevention in any woman and especially one with a history of cancer in the family. We know that more than ten years of hormone therapy will increase the breast cancer risk. The new estrogens are modeled on Tamoxifen which acts as an estrogen blocker in the breast. The problem is that women who take Tamoxifen for five years have protection of their breast and women who take it for ten years have more cancers. Thus the new estrogens are likely to give only short term protection. Herbal remedies such as black cohash or don quai work very well. Menopause is natural and we don't have to take anything.
Dr. Charles Hammond responds:
If there is a primary relative with a history of breast cancer, your risk of breast cancer is modestly increased. However, there are studies to suggest that while your risk is increased because of the previously-noted reason, adding replacement estrogen does not further increase your risk of breast cancer. Certainly, you might benefit in the cardiovascular, bone and possibly brain protection, as well as control of the symptoms of hot flushes and atrophic changes.
There are new hormones being developed that may separate traditional estrogen effects on breast, vagina, uterus from the protective effects on bone and cardiovascular system. These are not yet even being tested in humans, and I predict they are a number of years from being available. I have addressed the issue of herbal remedies or phytoestrogens (plant estrogens) in the preceding question.