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Wednesday, December 15, 2010

Menopause Hormone Therapy~


Menopause Hormone Therapy: Studied or Understudied?

By Ellen Sarver Dolgen

Do we really have to scare every woman in perimenopause and menopause (PM&M) half to death...again?

I have read article after article, listened to the news and talk shows and I am getting more and more frustrated!  So, I began reaching out to the sisterhood and speaking with doctors, pharmacists, and scientists about their thoughts on the latest findings of the recently released (October 20, 2010) follow up to the WHI 2002 study.

The 2002 WHI study on hormone therapy was halted due to the increased risks of breast cancer, stroke and heart disease in the women using Prempro vs. the placebo. Many scientists and doctors who have studied this report are quick to point out that the study was flawed, and the latest results and press coverage from it have perpetuated unnecessary fear.

The average starting age was 63 years old and many of these women were already on drugs for other conditions, including heart conditions. I am not good at math, but here is the part that sounds scary: a 1.3 person increase in breast cancer deaths per year for every 10,000 women.  Again, this is with specifically Prempro being used by mostly post-menopausal women.

Prempro is made up of conjugated equine estrogens (Premarin) and a progestin called medroxyprogesterone acetate (Provera).  These estrogens were derived from the urine of pregnant mares and therefore were comprised of estrogen made by horses.  I love horses, but this form of estrogen is not the same as what the human female body makes.

If you ask a room full of perimenopausal women today what kind of hormone replacement therapy they’re on, you would probably find that a tremendous number are on a transdermal bioidentical estrogen called estradiol and a bioidentical progestin called progesterone. These options, in contrast to Prempro, are hormones that are made to be identical to the hormone produced in our bodies.

My head is left spinning with questions:

  • How does the 1.3 per 10,000 increases in breast cancer deaths relate in a risk/benefit analysis with the benefits of estrogen therapy, such as hip-bone fracture and heart disease prevention?
  • Who is studying the PM&M woman who is on bioidentical hormones?  Is there a study that says a woman on transdermal bioidentical estradiol and bioidentical progesterone has an increase risk in breast cancer?
  • If we start bioidentical hormones when we are in perimenopause, how long can we stay on these hormones?  For example, before age 60 is it beneficial to stay on HRT and then after age 60 does the risk/benefit get reduced?
  • Do we have a recent study on the affects of drinking and eating soy products?
  • What does the existing international data on hormone therapy tell us about the affects of HRT on a woman’s lifespan?

What I’m getting at with all these questions is that more needs to be done. And not just by doctors. We, as strong empowered women, need to be doing our part. Whether it’s joining support groups; letting our doctors know everything that’s on our mind — our fears, worries, etc. — or calling up the researchers ourselves and demanding they do more. We have to be proactive if we don’t want our daughters and granddaughters to have the same questions we all have today.

"E" is the pen name of Ellen Sarver Dolgen, author of Shmirshky: the pursuit of hormone happiness, a light-hearted, informative, easy-to-read book on menopause, and creator of, a resource treasure trove for women going through menopause and perimenopause (PM&M for short). E stands for everyone because everyone goes through menopause or knows someone who does. She currently serves on the Community Advisory Board of Scripps Memorial Hospital La Jolla. She has served on boards, committees, and chaired numerous events for Fresh Start Women’s Foundation, Angel Charity for Children, San Diego Hospice. Brandeis University, the Phoenix Heart Ball, Juvenile Diabetes Research Foundation, Weizmann Institute of Science, Brewster Auxiliary, and Handmaker Home for the Aging. Ellen’s lifelong commitment to philanthropy through board representation, fundraising, and event organization continues with her founding of Shmirshky Universal, which aims to promote women's health and well being around the world. For more information, visit

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