News flash! An interesting article was just published showing that estrogen hormone replacement therapy (HRT) in women who have already had a hysterectomy (had their uterus removed) is associated with reduced mortality in women age 50-59.
Let’s review the nuts and bolts of HRT. For post-menopausal women who still have a uterus, they need to take two hormones: estrogen and progesterone. For women who do not have a uterus, they need to take only estrogen. These hormones can be given by mouth, as a patch, as a spray, or as a gel. Regardless of which method is used to receive the hormone, the goal is still the same: decrease the symptoms of menopause, and as the study suggests, reduce the chances of premature death.
In 2004, you might recall a study called the Women’s Health Initiative (WHI) that showed there were adverse effects in post-menopausal women who were taking hormones compared to those women who weren’t taking any hormones. I remember that the day the story broke, the study received tons of media attention. Millions of women stopped taking their hormones and suffered with hot flashes, night sweats and all the other good stuff that comes along with menopause. Well, it looks like we need to rethink HRT again. Confused? Don’t know what to believe anymore?
Here’s what happened: In 2011, a follow up study to the WHI showed that there were mortality benefits (yes, benefits!) for women aged 50-59 who were taking estrogen only for HRT , and possibly a decreased risk of breast cancer. Not only did this group of women have decreased mortality, but the decrease was primarily in heart disease which is a top killer of women in the United States!
Despite this information, women are not using HRT as much as they used to. It appears that less than 30% of women who have had a hysterectomy are taking estrogen. So, the newest study tried to figure out how many women died prematurely because they did not take their estrogen. The number they came up with was a minimum of 18,600, but it could be as high as 91,600 women. Holy smokes!
And there’s more. This was a study that appeared in a top medical journal, so, I am inclined to believe the results. I also notice how much better many of my patients feel when they get a little estrogen back. So, here’s a message for all you 50-somethings out there: If you do not have a uterus, please speak with your doctor about starting estrogen replacement therapy. It might be just what the doctor ordered.
Lara Burrows, M.D.
The Center for Vulvar and Vaginal Disorders
Summa Akron City Hospital
Summa Health System