Low-dose estrogen can be taken orally, but it is also now available in patches, gels, and creams.
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Low-dose estrogen can be taken orally, but it is also now available in patches, gels, and creams.
svetikd/Getty Images
The benefits of hormone therapy to treat menopausal symptoms outweigh the risks.that’s the conclusion new research Published in a medical journal jam.
“We found that women under 60 years of age had a lower risk of adverse events from hormone therapy. [is] Safe for treating pesky hot flashes, night sweats, and other menopausal symptoms,” study authors say Dr. Joan Manson, Director of Preventive Medicine at Brigham and Women’s Hospital. This is very different advice than many women have been given in the past.
The new analysis is based on 20 years of tracking data. research on women’s health initiatives; The study followed thousands of women undergoing hormone replacement therapy. The study was stopped after it was found that women taking Prempro, a combination of estrogen and progestin, had an increased risk of breast cancer and stroke.
“The results were surprising,” Professor Manson said, adding that the randomized trial was carried out because scientists were trying to determine whether hormone therapy reduced the risk of heart disease and other diseases. he pointed out.
Many women suddenly stop treatment after the first findings occur. Although prescriptions have plummeted, many health care providers remain hesitant to recommend hormone therapy. But menopause experts say it’s time to reconsider hormone therapy, because much is known now that wasn’t known 20 years ago.
Most importantly, there are now different types of hormones that are proven to be safer and administered in lower doses.
“Women should know that hormone therapy is safe and beneficial,” says Dr. Dr. Lauren Streicherclinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.
Dr. Streicher said that in retrospect, it is clear that the Women’s Health Initiative study was flawed, and that some of the risks identified were related to the type of hormones given to women. It has said.
“We learned what not to do,” Streicher said.types of progestins used, known as Medroxyprogesterone acetate, “It was very problematic,” she says. This may be the reason for the increase in breast cancer seen among the women in the study. “So we don’t prescribe it anymore,” Streicher says.
Other types of hormones are increasingly being used. Micronized progesterone It does not increase the risk of breast cancer,” says Streicher. bioidentical hormones It has the same molecular structure as progesterone produced in women’s ovaries and tends to have fewer side effects.
Another issue with this study was the age of the women enrolled. Most of the women were over 60, Streicher said. “And we know that we have a window of opportunity when it’s safest and most effective to start hormone therapy.” That age group is typically between 50 and 60 years old. she says.
Another risk identified in the Women’s Health Initiative study was an increased incidence of pulmonary embolism among women taking hormone medications. A pulmonary embolism is a blood clot that blocks blood flow to the lungs.
The women in the study were taking estrogen by mouth in pill form, which may have increased their risk, Streicher said. A better option for people at risk of blood clots is to take estrogen through the skin through patches, creams, or gels.
“The advantage of transdermal estrogen is that it is not metabolized by the liver,” Streicher says. “And because it’s not metabolized by the liver, we don’t see an increase in blood clots.”
With the variety of hormone treatments now available, Dr. Streicher says there is no one-size-fits-all approach. “Hormone therapy is beneficial for much more than just relieving hot flashes,” she says.Ongoing research indicates that Protection against bone loss and heart diseasetoo.
Streicher says women should talk with their health care provider about the options that best suit their needs.
This article was edited by Jane Greenhalgh
