Newsflash: So, estrogen is safe?

Posted by Liz on Jul 22, 2013 in estrogen | 5 comments

If you’ve been following this blog for any period of time, you know that I’ve consistently shared data that demonstrate the hormones, particularly combination hormone replacement therapy (HRT) can be dangerous, depending on age, time since menopause and other concomitant health issues. Yet, the medical community continues to beat the dead horse of trying to prove the hormone replacement in any form has a role in women’s health. And because I have promised to share the facts, regardless of whether or not I have questions about the motivation underlying their derivation, I am writing this post.

According to research appearing in the July 28 online issue of the American Journal of Public Health, estrogen actually prevents deaths among women who have had hysterectomies. By the way, that’s estrogen ALONE, not estrogen plus progestin, and that is a critical distinction.

Onto the findings. When researchers took another gander at the Women’s Health Initiative data, they sought to determine how the rate of excess mortality among women who took placebo versus those who took estrogen over the course of the landmark study actually translated into premature deaths that might have been preventable. And what they found is pretty shocking:

• The researchers looked at deaths in women who had undergone hysterectomy and still had an ovary intact compared with those who did not have any ovaries (note that sightly more than half — 54% — of women have both ovaries removed at the time of hysterectomy)
• They also examined the use of oral estrogen among the 50 to 59 year old set between the years 2001 and 2004, noting a decline by as much as 60% (largely the result of the the findings of the Women’s Health Initiative) and a relative decline by as much as 71% by the year 2009.
• In composite, they were able to calculate that between 2002 and 2011, a least 18,601 excess deaths occurred and as many as 91,61o excess deaths occurred among women who had had hysterectomies and chose not to use estrogen. This translates to an actual toll attributed to the decision of 40,292 to 48,835 deaths.

The researchers say that estrogen therapy alone reduces mortality mainly by reducing the number of heart disease-related deaths; notably early surgical menopause and complete removal of the ovaries boost the risk for coronary heart disease. Estrogen prevents the development of atherosclerosis and helps maintain normal blood flow.

It’s important to remember that these findings do not apply to women younger than age 50 or older than age 59. Moreover, they also fail to consider other reasons for the increase in heart disease among women as their estrogen declines, such as a surge in cholesterol. And, despite the improved odds against dying from heart disease, these data also ignore other health issues associated with estrogen alone, such as incontinence, hip fracture and of course, breast cancer among certain subsets of women. Hence, again, I am forced to ask the question why researchers continue to beat this horse to death when the deaths prevented may carry the cost of other issues?

I don’t believe that this is anything that will be resolved any time soon. And, as I have written previously we’re drowning in politics, medicine and industry. And it’s difficult to discern truth from fiction, data from data, risk from benefit. Ongoing analyses will eventually reveal what’s what. Meanwhile, read the library of HRT posts on Flashfree. Talk to your physician. Avoid hasty decisions. And consider alternatives. If the medical community can’t agree, perhaps it’s time to put down the gauntlet and wait out the firestorm.

The choice is yours’. Which side are you willing to err on?