Estrogen Therapy Has Many Valid Uses, But Many Health Risks Are Associated With Long-term Use
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Estrogen therapy has many valid medical uses. Whether or not estrogen therapy or hormone replacement therapy of any type is safe for long term use is debatable. Women who have low estrogen and lower than normal levels of other hormones, because of surgery or injury to the ovaries benefit greatly from hormone replacement therapy, but in women going through natural menopause, the increased health risks outweigh the perceived and measurable benefits.
Researchers from the Women’s Health Initiative have shown that equine estrogen therapy used for five years or more increases a woman’s risk of developing blood clots and stroke. The commonly used combination hormone replacement therapy, which includes equine estrogen and a synthetic progestogen, increases a woman’s risk of developing heart disease and breast cancer, as well as blood clots and stroke. For many years the combination therapy was believed to be safer than estrogen only, because it decreased a woman’s risk of developing endometrial cancer.
There is some debate about whether or not bio-identical hormone replacement therapy poses the same health risks as other types, but no studies have been conducted concerning this subject. Bio-identical HRT has gained in popularity, even though it is more expensive and unavailable from many doctors, because women assume that it is safer and more natural, but there is no scientific evidence supporting this belief. Bio-identical hormones are still created in a laboratory, using plant and animal hormones that have been modified to be molecularly identical to those of a human being.
It is known that estrogen therapy effectively controls excessive or abnormal uterine bleeding. When used for this purpose, doctors use a relatively high dose to cause the uterine lining to build up quickly, thus reducing or preventing the bleeding. This type of estrogen therapy is only used for a short period of time, usually four to six weeks and is not believed to cause any long-term side effects.
It is a commonly held belief that low estrogen levels leading up to and following menopause causes hot flashes, but no one is sure. Low-dose estrogen therapy seems to relieve these symptoms in some women, but not in others. Many doctors do not bother with lab tests to check hormonal levels. For many years, it was easier to prescribe a “pill” that was believed to be safe, but because of years of research, most doctors do not recommend HRT for mild to moderate menopausal symptoms. Doctors that provide bio-identical hormones must check hormone levels to verify, which hormones need to be replaced.
Birth control pills contain a form of both estrogen and progesterone. So, many women have been using a type of “estrogen therapy” for years before they enter menopause. It is known that birth control pills increase a woman’s risk of blood clots. Additionally, women who smoke and take the “pill” have an increased risk of heart attack. Adding more hormones to this equation that can “possibly” reduce the symptoms that “may” be caused by low estrogen levels, when there are safer alternatives, does not seem appropriate.
Safer alternatives to estrogen therapy for women going through menopause include dietary and lifestyle changes, nutritional and herbal supplementations or possibly estrogen creams. Most researchers agree that topically applied estrogens to relieve vaginal dryness and improve vaginal health carry few if any of the risks associated with orally administered estrogens.
Related: Estrogen Therapy Has Many Valid Uses, But Many Health Risks Are Associated With Long-term Use
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