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On July 9th, 2002, the Woman's Health Initiative study (WHI) came out and (with the help of the media) scared half the world's women on hormones into quitting them for fear of breast cancer and heart disease. Well finally more rational heads in the Gynecology community are getting some play in the media.
Here is an article which summarizes my beliefs regarding hormone therapy... and I believe, in time, the world will realize that the 60+ articles which showed estrogen reduced heart disease were not a lot of bunk.
Health Tips ... from UPI
IN HORMONE THERAPY, TIMING COULD BE EVERYTHING
Researchers say the timing of treatment may be a key to whether hormone replacement therapy can slow heart disease in postmenopausal women. "Mounting evidence points to the conclusion that HRT can help prevent heart vessel disease -- if the therapy begins around the time that the body stops making its own estrogen," said Thomas Clarkson of Wake Forest University Baptist Medical Center. "The question may not be if estrogen helps, but when is the optimum time to begin therapy."
Clarkson, a professor of comparative medicine, and Dr. Richard Karas, director of the preventive cardiology center at Tufts-New England Medical Center, reviewed studies of postmenopausal women and monkeys that evaluated the cardiovascular effects of HRT. Their analysis, published in the journal Menopausal Medicine, included the Women's Health Initiative, which showed an increased risk of heart attacks in women taking HRT and led to recommendations that women not begin hormone replacement therapy for the purpose of preventing heart disease. They also reviewed trials of postmenopausal monkeys conducted at Wake Forest during the past 12 years.
"The literature demonstrates that HRT has beneficial effects in inhibiting the early stages of heart vessel disease, but can have deleterious effects if initiated at older ages when some women have already developed disease," Clarkson said.
So what this is saying is that if you start your hormones at menopause (when your periods stop and when your hot flashes begin - usually around age 50) you are probably preventing heart disease, (i.e. preventing hardening of the arteries.) On the other hand, if you begin your hormone therapy after age 60, after you've already developed hardening of the arteries, you are probably increasing your risk of heart disease (i.e. like a heart attack.)
The patients in the WHI study averaged 63 years of age and many of them were more then 10 or even 20 years past menopause. 20% of them were older than 70.
In these women, hormones increased heart disease somewhat. (So I'm no longer advising any 60 or 70 year old patients to begin hormone therapy.)
The final answer is not yet definitely known, but when it is I'll bring it to you.
Now if anyone wants to see the very academic and very technical 12 page journal that analyzes the WHI study in great depth, click here for the entire journal Menopausal Medicine:==> Click Here for Menopausal Medicine
The above is not meant to be medical advice. Please read the attached Disclaimer, Etc.
Best wishes. Dr. Rehert
Best wishes. Dr. Rehert
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