Hormone Therapy? Fear Not

To all my newly menopausal women friends (and to women everywhere) who are suffering from lingering, way-down-in-the-dumps depression, sweating through two pairs of pajamas per night or flashing like a smoke alarm out of batteries at the most inconvenient or embarrassing times: It’s time to put aside your fear of hormone therapy.

I’m not a doctor, so don’t take my word for it. Take the word of Sharecare expert Lauren Streicher, MD: “Women who are having a difficult time with menopause do not have to have the mindset that they’re taking their life in the hands if they choose to take a little bit of estrogen.”

This is not really news. Back in July, 15 major organizations released a joint statement reassuring women that hormone therapy is an acceptable, relatively safe way to treat menopause symptoms. But yesterday, preliminary results of a new study were announced that support that notion.

What the KEEPS study found
The Kronos Early Estrogen Prevention Study, or KEEPS, found that healthy, newly menopausal women who took hormone pills or patches got relief from symptoms like hot flashes, depression and night sweats and didn’t suffer any negative effects on their blood pressure or cholesterol, or any increase in factors associated with blood clots, over the four-year study. Some women saw their cholesterol go down.

None of this comes as a big surprise to Dr. Streicher or to many other doctors or researchers.

An earlier, larger study known as the Women’s Health Initiative (WHI)—the study that struck fear in the hearts of women a decade ago—did find an increase in the risk of heart disease and stroke in some women who took hormones, but that study involved much older women who were far past the onset of menopause, and many of them already had high blood pressure and cholesterol at the start of the study.

The WHI also involved higher doses of hormones, and the hormones themselves weren’t exactly the same. The women in the WHI study took Premarin (estrogen derived from pregnant mare urine) plus Provera, a synthetic form of progesterone. (In women who still have a uterus, progesterone is taken along with estrogen to decrease the risk of uterine cancer.) In the KEEPS study, women took either a lower dose of Premarin or an estrogen patch containing estradiol (made from plants), plus natural, not synthetic, progesterone.

As in comedy, timing is everything
The key, says Streicher, is timing. “It’s really is about this critical window—if you give hormones at the onset of menopause, the issues seen in WHI in terms of blood cots and other complications just don’t seem to be a problem.”

In other words, taken at the right time and in small dosages, hormones aren’t likely to increase your stroke or heart attack risk, or your breast cancer risk—and will protect your bones and possibly, just maybe, your brain and blood vessels too, says Streicher.

Robin Miller, MD, co-author of The Smart Woman’s Guide to Midlife and Beyond, also wants to reassure women that taking hormones isn’t a crazy idea. “Women who are in early menopause with symptoms can safely take hormone therapy,” says Dr. Miller. She adds this caution: Make sure you’re getting progesterone, not progestin.

Both doctors prefer transdermal hormones (patches, gels, sprays, cream) over pills. For starters, they are less likely to affect heart disease markers such as c-reactive protein and more likely to decrease insulin resistance, says Streicher. And longer-term studies show that pills are more likely to cause clots, says Miller (although the KEEPS study didn’t show an increase in clotting from pills).

I admit it—I’m dreading menopause. But at least I know that if I need to turn to hormones to help me cope with symptoms, I won’t be giving myself one more thing to worry about.

Would you take, or have you taken, hormones for menopause symptoms? Let us know in the comments box below.

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Marianne Wait

A devoted health junkie, Marianne believes that information plus inspiration equals action. She spent many years at Reader’s Digest creating health books designed to help people understand complex health topics and achieve their health goals, from lowering their cholesterol and blood sugar to losing weight to sharpening their brain power.

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