The last decade has meant conflict and confusion for menopausal women and those who had hysterectomies. Hormone replacement therapy had helped relieve women's hot flashes and night sweats for years, but then a landmark study was stopped in its tracks when an interim review of the Women's Health Initiative showed estrogen and progestin combined increased a women's risk of breast cancer.
"There was a huge decline and people everywhere became terrified that they were going to get sued because they caused a patient's breast cancer. So, they stopped prescribing hormone replacement therapy, even for young women that really needed it," said Dr. Elizabeth McGee, a gynecologist at Fletcher Allen Health Care in Burlington.
But slowly, with new research, that's changing-- especially now, with a brand new analysis of the Women's Health Initiative trial.
Researchers looked at data from women aged 50-59 who had undergone hysterectomies. The results showed that many women who were avoiding estrogen actually died prematurely. The most conservative estimate placed the total number of deaths at more than 18,000 over the last 10 years, with the study's authors saying the toll could be as high as 91,000.
But why? Why was a lack of estrogen killing women?
"The big ones are cardiovascular disease, osteoporosis and hip fractures, and probably a little less so, gastrointestinal cancer," McGee said.
Today, McGee says it's all about balance. Estrogen replacement for women at risk of breast cancer or blood clots is not recommended. But she says it could be beneficial for those with a family history of heart disease or osteoporosis.
"You have to look at every patient as an individual because some people need to be on estrogen and other people have incidents in the personal family history that means it's not a good idea. It's a balance," McGee said.
A balance between the pros and cons of estrogen, no longer seen as the enemy. Doctors say the new findings may mean the difference between life and death for many women facing menopause.
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