|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.
Gloria Roffman, Richmond, VA asks:
Have there been any studies done as to the number of women who suffer from migraine headaches, heavy bleeding, frequent periods, mood swings, hot flashes, etc. in relationship to the number of women in the work force and time lost?
Dr. Susan Love responds:
It is a good question but I have not seen such studies. The symptoms you describe are from perimenopause and are the result of hormonal fluctuations. You can think of it as puberty in reverse. And like puberty they are transient and usually resolve within 2-3 years. If they are interfering with your life you can consider hormones or alternatives. For symptoms you take hormones for 3-5 years and then you taper off.
Dr. Charles Hammond responds:
There are limited data in the literature discussing the number of women who have significant menstrual complaints and time lost in the work place. I doubt their accuracy. However, they do not discriminate well between the efforts women make when they are having some symptoms and yet still work. Migraine headaches have been shown in some patients to be triggered by sharply rising and falling estrogen levels, and it seems that a steady state may be better. Heavy bleeding requires evaluation to seek the cause. It may vary from disordered ovulation to polyps or growths in the uterus to malignancies or other problems.
An evaluation is mandatory before any hormonal therapy is considered. The same is true with episodes of too-frequent bleeding. There are limited data to suggest that depression may have a relationship to low estrogen concentrations and that cognitive function is improved among women in whom there is reasonable estrogen present. Exciting preliminary data, not yet fully proven suggest that the rate of occurrence and the age of onset of Alzheimers may be diminished in women who take estrogen.