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New Findings, New Thoughts
A VIEW ON ESTROGEN REPLACEMENT
Are the side effects of estrogen replacement actually caused by estrogen?
What happens when a post-menopausal woman begins hormone replacement therapy with
estrogen or estrogen and progesterone?
Most young adult females have adequate, healthy, levels of the three ovarian
hormones, estrogen, progesterone, and testosterone. The secretion of these hormones by the ovaries is stimulated
and controlled by the pituitary gland. About ten years before the menopause the ovaries start to lose the ability
to secrete testosterone. At the menopause estrogen and progesterone fall to inadequate levels and menstruation ceases.
The post-menopausal woman is left with insufficient amounts of the three hormones to maintain a strong, healthy,
vigorous, sexual, life, but the hormones are not completely absent. The pituitary gland, connected to our
brains, is trying mightily to keep the ovaries functioning as much as possible.
Now the woman decides to begin hormone replacement therapy and starts
taking estrogen or a combination of estrogen and progesterone. What happens? The woman once again has a
younger, adequate, amount of estrogen in her body. The pituitary gland senses this and stops trying to
force the ovaries to produce hormones. The ovaries go to sleep, and her testosterone level falls to essentially
zero. It is commonly undetectable.
From a common sense point of view, which is more likely to cause medical
problems such as vascular disease, phlebitis, or the question of breast cancer, the re-establishment of healthy
levels of estrogen, or the complete loss of testosterone?
nbsp; (3/7/08)
Those women with the highest estrogen levels, young adults, rarely suffer
from the above diseases. There are, however, many published studies which show a strong correlation between
the absence of a woman’s testosterone and the presence of coronary artery disease and clogged peripheral
arteries. A recent study demonstrated that the combination of estrogen and progesterone stimulated breast
cells, but if testosterone was added to the combination the breast cells were unaffected. The abstracts
of these studies are among the many dozens that can be viewed on this website under "Medical Studies".
3/7/08
The NIH issued a press release on March 4 concerning the Women's Health
Initiative Study:
"WHI Follow-up Study Confirms Health Risks of Long-Term Combination Hormone Therapy Outweigh
Benefits for Postmenopausal Women
New results from the Women's Health Initiative (WHI) confirm that the health risks of long-term use of combination
(estrogen plus progestin) hormone therapy in healthy, postmenopausal women persist even a few years after stopping
the drugs and clearly outweigh the benefits. Researchers report that about three years after women stopped taking
combination hormone therapy, many of the health effects of hormones such as increased risk of heart disease are diminished,
but overall risks, including risks of stroke, blood clots, and cancer, remain high. The WHI is sponsored by the National Heart,
Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH)."
What is more likely to have happened here? Once the estrogen and progestin were
stopped the women's pituitaries again began to secrete ovary stimulating hormones, most likely again in amounts that far
exceeded anything secreted pre-menopausally. These ovaries had been resting quite a while and likely were able
to produce more
testosterone than they had when the study began. Common sense and logic would tell us that it is
this restoring flood of testosterone that
is responsible for the decrease in heart problems, not the absence of younger levels of estrogen and progestin.
When it comes to the risk of cancer, there will be cancers found that began during
the time of severe testosterone deprevation but which are not yet detectable.
I predict there will be a continued higher incidence of cancer as these tumors are diagnosed, then a sharp drop-off to
very low risk as
we see the results of the restored testosterone phase. I also predict that we will much sooner hear that the risk of
strokes and blood clots has diminished just like the heart disease risk.
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