The midlife transition can be difficult for many women. Sex hormone levels such as estrogen, progesterone and testosterone drop dramatically. This may seem, to many, to be part of the natural process of aging. After all, such high levels of hormones are no longer being produced to facilitate reproduction.
In reality, women have receptors for sex hormones, in particular, estrogen, all over their bodies. Sex hormones are needed for more than sex and reproduction. They are needed to protect bones, strengthen muscles, and help cognition.
The human brain is loaded with estrogen receptors, especially in the area dealing with memory. Many women will laugh at their “senior moments” when they forget the name of a person, place or item. But let’s face it, who wants to have a senior moment at the age of 48 or 50? If we are having difficulty at this age, do you think it will get any easier? It may be worth considering hormone replacement if only to save a brain!
Many people are concerned about the safety of hormone replacement since the results of the Women’s Health Initiative Study were released about 10 years ago. This study was terminated early with the researchers concluding that there may be more harm than benefit for hormone replacement. Newspaper headlines blamed this conclusion on the increase in breast cancer. Women everywhere threw out their hormones, and either converted to herbs or suffered through the hot flashes and other adverse effects of menopause.
Unfortunately, the real story became hidden as headlines continued to rally against using hormones. The story I tell all my patients, in regards to breast cancer is this:
- There were three categories of women in this study:
- women taking no hormones
- women taking “estrogen only” (in the form of premarin, a horse estrogen)
- women taking “estrogen and progesterone” (in the form of premarin and progestin, a synthetic progesterone)
Each division had approximately 10,000 patients. There were 30 cases of breast cancer over the 5 year period in the “no hormone” group. There were 38 cases in the “estrogen-progesterone group”. This means an increase occurrence of breast cancer in the “estrogen-progesterone” group of 8 cases per 10,000. This is less than 1 per 1,000; a very minimal number, quoted in the research as of “nominal statistical significance”. Here is the exciting part; the “estrogen-only” group had less breast cancer than the “no hormone” group, and continued to have less breast cancer in follow up studies done 8 years later.
It is time to view hormones in a helpful light instead of as villains, causing cancer and damage to the system. Estrogen can help women to extend their life and be healthier if administered with care. Bones, heart, skin, oh, and let’s not forget the brain may depend upon it.