|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.
Online NewsHour Editors ask:
The American College of Obstetrics and Gynecology has recommended that postmenopausal women take replacement hormones for the rest of their lives. But if someone is in their mid-80s or 90s won't their bodies "expect" to have lower levels of estrogen? Could women start overdosing their systems?
Dr. Susan Love responds:
As you well point out it is not normal to have high levels of hormones your whole life. Some have argued that it is the high levels of estrogen we are exposed to premenopausally that is the cause of the increase in breast and ovarian cancers. Taking postmenopausal hormones is like taking any other drug which is not normally in your system. There may be reasons to do it, but it isn't normal.
Dr. Charles Hammond responds:
If a patient is taking estrogen, and, if she has a uterus in place, also taking progestin, I see no reason to stop the medication at any age if she is doing well without side effects. The classic dosages used are at the lower end of the scale, and I do not believe they offer significant risk, even in the older patient. There are data to suggest that even women who are older (70s and 80s) may benefit with bone protection from adding estrogen, as well as cardiovascular protection and the avoidance of coronary atherosclerotic disease and heart attacks. In all cases, one is trying to utilize the medication to provide a healthy status for whatever the duration of that individual's lifespan will be.
Since this is not predictable, I see no particular reason or gain to withdraw the therapy prematurely. I would anticipate that within the next five to ten years we will have significant other choices to treat specific menopausal conditions and disease states that increase after menopause. Thus, I am not sure that one needs to worry now, starting the medications, that you will still be on them thirty years later. You may, you may not.