Estrogen Therapy Continued (10 years later)

In 2002, the WHI (Women’s Health Initiative) shocked the world.  Ever since, there have been numerous, ongoing studies that have shed a more favorable light on Estrogen therapy. Here are the favorable findings:

1. 10 years since the WHI findings, the following has been noted:
   1. Patients on Estrogen alone had a reduction in breast cancer which continued even after the Estrogen was stopped.
   2. Patients who started Estrogen therapy early in menopause (age 50), who were followed for the next 10 years (ages 50-59), had a reduction in heart disease and death.
   3. Patients on Estrogen alone, over the 10 year period and through their mid-60’s, had an overall reduction in illness and mortality.
2. There is growing evidence that transdermal (Estrogen transmitted through the skin) Estrogen therapy doesn’t increase the risk of stroke or blood clots even in women continuing treatment into their 60’s.

Take home message:  In early menopause, Estrogen therapy is not only safe for a period of the first 10 years but it also reduces the risk of heart disease and breast cancer.  Today, I am less reluctant to continue patients on transdermal Estrogen into their 60’s if their symptoms warrant!

National Heart, Lung, and Blood Institute.  (2011). Update on the Women’s Health Initiative Estrogen – Along Trial. Retrieved from https://hp2010.nhlbihin.net/joinhin/news/professional/whi.asp

 Schierbeck, LL & Rejnmark L, tofteng CL, Stilgren L, Eiken P, Mosekilde L, et al. (2012). Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial.   BMJ, 345, e6409. doi: https://dx.doi.org/10.1136/bmj.e6409

 Sifferlin, Alexandra. (2012). Heart benefits from hormone replacement therapy? Time. Retrieved from:  https://healthland.time.com/2012/10/10/heart-benefits-from-hormone-replacement-therapy/