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[Melbury]

Very interesting post.

My gynaecologist told me that the infamous 2002 WHI study was based on both oestrogen and progesterone HRT being given to women who were predominantly 60+ - I don't know whether that is true or not.

He was of the opinion that oestrogen only HRT used by women who had undergone a hysterectomy was in fact very beneficial and, as in your post, can actually lower the risk of breast cancer and of course help bone density.  He said that it is the progesterone that is the baddy in the equation.

I personally don't know enough about the subject to say either way, however, I do know that in the few years I have been using Oestrogel, I have felt better, so I certainly don't want it taken away from me just because some doctor says I have been on it long enough.

[donnawalters]

Your doctor was correct. The study results announced were for women taking estrogen plus progestin, and the participants were over the age 60.  This means they were already predisposed to any diseases before they entered the study.

This is the WHI statement posted regarding the results of that study, "Estrogen plus progestin does not confer cardiac protection and may increase the risk of CHD among generally healthy postmenopausal women, especially during the first year after the initiation of hormone use. This treatment should not be prescribed for the prevention of cardiovascular disease."

Concerning breast cancer, the WHI posted statement states -- "Relatively short-term combined estrogen plus progestin use increases incident breast cancers, which are diagnosed at a more advanced stage compared with placebo use, and also substantially increases the percentage of women with abnormal mammograms. These results suggest estrogen plus progestin may stimulate breast cancer growth and hinder breast cancer diagnosis."

However, later statements have re-assessed these interpretations by advising that the risk is very small in both cases.

Again, what is NOT known is what is the health of the long-term estrogen users, including birth control pills.  Until the data is received by the observational study we will be conducting, no one will know what helps to make women healthy in their later years.  The life expectancy of women today has now reached 81 years.  Many statements are now advising that the women of today will spend almost HALF of their lives in a post-menopausal state of health. 

Our study has two important goals:  1) to acknowledge that special group of long-term estrogen users, many of whom probably have never experienced menopause (like me--I couldn't even tell you what a hot flash is & I am a few years from 70), and 2) to see what their health and quality of life have been like.  The topic has surfaced many times that women have been given the wrong information about estrogen for years.  Everyone must realize there are two types of doctors relative to estrogen use:  1) doctors who support estrogen use, and 2) doctors who oppose estrogen use.  The problem lies with HOW DOES ANYONE KNOW WHICH DOCTOR'S MEDICAL OPINION IS CORRECT?

Someone, somehow, must find an answer to provide women with the correct medical information, not just an individual doctor's opinion, or incorrect study results, in order to bring women's health issues to a higher level of priority.  That's what we are going to try to do. For more info, please visit my website, EstrogenInternationalAssociation.com.

[Hurdity]

I am a bit tired at the moment, but just really to say - we cannot simply talk about "oestrogen" as a whole without differentiating between synthetic oestrogens (as in the contraceptive pill), "natural" but "foreign" oestrogens as in conjugated equine oestrogens, and oestrogen as in those native to the human body of which I understand there are many, chief of which are oestradiol, estriol and estrone.

Quite often writings about this subject lump them altogether, which in my opinion is like treating the effct of painkillers altogether ie saying what is known about the effect of aspirin is the same as that of paracetamol!

The observational study you mention donnawalters will be interesting but of course only randomised placebo controlled trials (such as carried out in the Womenn's Health Initiative Study - but properly!) will give us the answers we need.

I absolutely agree, that especially due to our increased life-span now, we desperately need information about the long term effects on women of taking oestrogen (in the form of oestradiol) with or without progesterone for long periods of time and especially beyond 60! Also long term effects of vaginal oestrogens.  This means there need to be large-scale trials of women taking these. There are some long-ish term studies - the Danish KEEPS study for one but this was intended to investigate heart disease I understand.

Re the doctor's medical opinion. In UK of course, we have the NHS but even so there is huge variation amongst individual doctors. This is mainly due to the fact that some have not read the scientific literature regarding current recommendations of the international menopause societies.

On this site we point women to these recommendations and the latest review papers - and the recommnedation from this website, but hard research data are still lacking.

Hurdity x

[donnawalters]

I am a bit tired at the moment, but just really to say - we cannot simply talk about "oestrogen" as a whole without differentiating between synthetic oestrogens (as in the contraceptive pill), "natural" but "foreign" oestrogens as in conjugated equine oestrogens, and oestrogen as in those native to the human body of which I understand there are many, chief of which are oestradiol, estriol and estrone.

Quite often writings about this subject lump them altogether, which in my opinion is like treating the effct of painkillers altogether ie saying what is known about the effect of aspirin is the same as that of paracetamol!

The observational study you mention donnawalters will be interesting but of course only randomised placebo controlled trials (such as carried out in the Womenn's Health Initiative Study - but properly!) will give us the answers we need.

I absolutely agree, that especially due to our increased life-span now, we desperately need information about the long term effects on women of taking oestrogen (in the form of oestradiol) with or without progesterone for long periods of time and especially beyond 60! Also long term effects of vaginal oestrogens.  This means there need to be large-scale trials of women taking these. There are some long-ish term studies - the Danish KEEPS study for one but this was intended to investigate heart disease I understand.

Re the doctor's medical opinion. In UK of course, we have the NHS but even so there is huge variation amongst individual doctors. This is mainly due to the fact that some have not read the scientific literature regarding current recommendations of the international menopause societies.

On this site we point women to these recommendations and the latest review papers - and the recommnedation from this website, but hard research data are still lacking.

Hurdity x

[donnawalters]

Different forms of hormones are recognized differently by cells, so it makes sense that their effects might also be different.

As stated in a Harvard Health Publication, "Technically, the body can't distinguish bioidentical hormones from the ones your ovaries produce. On a blood test, your total estradiol reflects the bioidentical estradiol you've taken as well as the estradiol your body makes. On the other hand, Premarin is metabolized into various forms of estrogen that aren't measured by standard laboratory tests. Proponents of bioidentical hormones say that one advantage of bioidentical estrogen over Premarin is that estrogen levels can be monitored more precisely and treatment individualized accordingly. Skeptics counter that it hardly matters, because no one knows exactly what hormone levels to aim for, and symptoms, not levels, should be treated and monitored."

There have been many studies on estrogen with the primary goal of researching whether it is safe or harmful relative to heart disease and breast cancer.  The observational study we are conducting is novel in that the goal is to collect important data of women who have taken any form of estrogen long-term to find out the results of their state of health and quality of life after taking it long-term.  No study of this kind as ever been conducted so it is not the usual estrogen observational study.  Let me explain further.  The number one cause of death among women is heart disease, more women die from heart disease than men.  It is a known medical fact that estrogen protects a woman's coronary arteries and once the estrogen is depleted, the risk of heart disease increases significantly. One in four women over the age of 65 has heart disease.  Equally important are the statistics of all female-related cancers.  It is a known medical fact that breast cancer increases with age.  As an example, at age 40, 1 in 68 women will be diagnosed with breast cancer, at age 50, it's 1 in 42, at age 60, it's 1 in 28, and at age 70, it's 1 in 26.  More than half of all endometrial cancer cases are diagnosed between the age groups of 50 to 69.  More than 20% of cervical cancer cases are found in women over 65.  Half of the women who are diagnosed with ovarian cancer are 60 years or older. This brings up the important comparison of women's health with and without estrogen.  Again, that's the focus of our observational study, not the different types of estrogen.

A study was conducted in January 2000 by National Institutes of Health to find out what the qualify of life is after the menopause process.  The results state, "Menopause causes a decrease in quality of life, which is dependent from age and other socio demographic variables."

The results of a study released in October 2012, reported, "A Danish study reported in the British Medical Journal has concluded that after 10 years of follow-up, women receiving HRT early after menopause had a significantly reduced risk of mortality, heart failure, or myocardial infarction, with no apparent increase risk of cancer, stroke or blood clot.  . . .  Re-analysis of these and other randomized trials have now shown that heart disease and total mortality are reduced when HRT is initiated in women aged less than 60 years, or within 10 years of menopause."

Our observational study should provide important data concerning all issues of a woman's health and quality of life.  Many women do not know that there are hundreds of thousands or maybe millions of women who have never endured menopause because they maintained their estrogen lifelong.  This type of data, which has never been collected, could be very important in knowing what will help keep women healthy after the menopausal years especially since the life expectancy age for women is now 81. Keep in mind there can be 35 negative medical consequences of menopause.

[Rowan]

Long long read but very interesting!

http://www.thedoctorwithin.com/women/every-woman-needs-to-read-this-chapter-now/

[Scampi18]

  I have also tried 3 types of hrt with no joy, I am applying a everol patch 100mg and testosterone gel at the moment, only been on it 2 weeks and feel absolutely rubbish, the mood swings and sweating are a 100 times worse than the last batch of hrt, crying I could fill a bucket daily, I don't even look like me,    period pains like I have never had before, migraine, rash and itching, tingling breasts, miserable so low.
I take thyroxine 75mg daily and I think it's interferring with each other, I also have fibroids.
Is it going to get better or am I going to murder someone, feeling very desperate at the moment.
I can't believe how something so natural can do so much harm to a person.

[Dancinggirl]

Hi and Welcome Scampi18
Do tell us a bit more about yourself.  Your age, where your are in your menopause etc.?
I assume you are seeing a prevaite gyane as testosterone isn't prescribed on the NHS.
Are you on Everol sequi or conti? Why such a high dose? If you have fibroids a high dose of oestrogen would makes these worse!!!
Do tell us which HRT types you have tried?
DG x

[Rowan]

I have often wondered why the cut off point for estrogen (HRT) was 60, it doesn't make sense that 59 you were OK but 60 the slippery slope!

I squirreled this away in my "Favourites" years ago and have just come across it today, it seems they were discussing this way back in 2005

http://www.futurepundit.com/archives/002631.html, it makes sense of the "window of opportunity" that experts talk about now.

The comments below the article are interesting too.

[Taz2]

I've found that 60 is also the "beware" age for other medications - especially those that you can get over the counter! This is the warning on my Canesten instructions

"Warning!
If this is the first time you have experienced symptoms of vaginal thrush, if you have had more than two infections in the last six months, if you are or could be pregnant, or if you are under 16 or over 60 years of age, you should make sure you consult your doctor before using this medicine."

Taz x

[peegeetip]

Just to say again in this central post.

There should be no cut off point for HRT if you dont want to stop taking it.

The recent BMS guidelines are also saying "no arbitrary limit" to how long we take HRT.

I've added this post which summarizes the details in there.

http://www.medicalnewstoday.com/articles/181726.php

Scroll down to the "New HRT Guidelines released" part on that link.

 

[Scampi18]

Sorry for non reply, been a bit unwell again, I am 51 started with peri at about the age of 45, always had problems with monthlys ever since I can remember, every two weeks I would get nervous and frightend of going out could never explain why, I had nothing to be frightend of I was only a little girl when it all began, hundreds of antidepressants later and therapy stillno better, found it difficult to conceive, just carried on best I could no one seemed to be able to help me, my 3 children were all born with problems hate lip and cleft palate, blindness in one eye, one kidney, then I was diagnosed with thyroid problems the same time as menopause, so hrt started and thyroxine still no better changed hrt one doctor wanted to have me sectioned I was a mess didn't know what the matter was, slept on and off back in 2009 lost my voice for 16 weeks had to stop working as could not function, I have been on climagest, climesse, oestrogen patches would not stay on, now on oestrogel and again don't think its for me I have been on it 3 days I am sweating more my extremities are so cold but I am flushed, shaking anxious, headache, but my head seems reved up, I have heard and read so much that eastrogen can cancel out thyroxine or I could be eastrogen sensitive, think I might call it a day with hrt, I have Merina coil fitted as well for the progesterone, and testogel for libido, not working so far, very disheartend with my gp who I have only been with for a year, won't listen to what I try and tell her I have such an extensive list of problems.
Ostioporosis arthritus I have had pernicious anaemia, bursitis, chicken pox lots of times, warts courtesy of x husband, just had laser treatment on eye for a tear in the back, don't know what's going to happen next, and unfortunately my daughter has all the same symptoms as I did, she also has a terrible gp. 
Sorry for the moan and negativity.

[Dancinggirl]

Moan away Scampi - sometimes we need to get things off our chests. 
I noticed your post about thyroxin and HRT - you got some good replies.
It sounds to me as though you need a thorough review of your situation.
Good luck  Dg x

[Kelly]

What a terrible time you are hving Scampi. Change your doc right away at least it might help I find hypnotherapy helps especially the relaxation part.
Keep us all posted.
Lots of love
Kelly xxxx

[Scampi18]

Saw a new gp today, fantastic very sympathetic, going for scan on my throat she could also feel the swelling, but the opposite side to what I could feel, lots of blood test again, also being refered to endo and ent for the meneries disease.
She is the first gp not to say do you think your depressed, I am very low but not depressed, it's just everything happening one after the other, thinks I maybe sensitive to eastrogen and having to much thyroxine, only on 75 which I take at night.
Think I will come off hrt and lower thyroxine see what happens.
My mind races and goes over and over things in my head, but it's not all the time just every now and again.
Thanks Kelly for the response.