Well obviously the tide is turning NOW regarding use of hormones in menopause. New studies/articles are posted on this website regularly showing changes in recommendations towards greater use. When the WHI study came out early this century, MANY women either stopped their hormones or were refused them by their doctors because of possible harm from cancer (and maybe fear of lawsuits here in US)....so yes, I think they were abandoned, for a while anyway. Older docs were willing to continue to prescribe due to vast experience and they are retiring or dying, but the younger ones still seem to be vary wary as just reading comments on this forum indicates. The warning leaflets now required on any hormone medication really exacerbated this also.
Breast cancer is such a "hot button" issue, but 3/4 of cases occur without family history and estrogen alone DOES seem to be protective. Colon cancer is clearly decreased by use of hormones, but no one seems to care about that. I also keep in mind that the interpreted results back then have been reexamined and some considered false. The statistic experts helped in forming those results back then and again have come out with this study, so I assume they could be over-reaching some with this study also. We need some "balance" which is never found on all these studies. If you get breast CA or endo CA, was it really caused by hormones? and if you get Colon CA or osteoporosis, was it really caused by NOT having hormones? What about the fact that some women's bodies make more estrogen naturally in menopause and some women's bodies don't make much. Blame is easy to throw around and the fear mongers (including some doctors) love to throw it.
However, estrogen is used by the body in many other places besides the reproductive tract as you know and deficiency or occurrence at menopause has been implicated in association with many diseases. I think the wide range of symptoms merely reflects how many parts of the body use estrogen. As the deficiency is felt differently amongst women, I think it stands to reason that some women could suffer unnecessarily or have died early due to refusal of hormones....the number is not something I could even guess, but somehow they scientifically? came up with a range. Osteoporosis is a well known problem and falls/hip fractures in menopausal women have a pretty impressive mortality rate, but I don't know the exact cause. Clearly suffering/death occurs due to osteoporosis and estrogen can prevent or lessen it! Heart disease occurs later in women than men, thought to be due to the protective effect of estrogen before menopause. Now they say you must take it early in menopause to get benefit, as starting later is associated with problems after the damage to the blood vessels has already occurred. Blood vessel damage (aging) occurs everywhere too, not just in the heart although this is not much talked about. Heart disease and strokes are related to blood vessel damage.
Clearly surgical menopause with hysterectomy done before natural menopause is the most severe situation so I guess that is why they used those women in analysis. But doesn't that mean that the number is even greater ( a wide range ) when you count those in natural menopause who didn't receive hormones and who have the more severe deficiencies? Women who were 48- 50 in 2002 are now 59- 61 and by standards in UK could not start HRT now...isn't that correct? Were those women who were afraid of HRT or whose doctors refused RX "robbed" of the opportunity to protect their heart and their bones? I am 57 and have had to really fight here in the US to get hormones in 2013 once I researched, quit listening to my own fear, and found different doctors. I had to pay out of pocket about 2K$ to get bloodwork and a hormone balancing doctor to work with me....insurance won't cover. These docs and clinics are springing up all over the US in the last 5 years which is opposing the "herd mentality" against hormone use and only using very low doses (possibly underdosing?).
I don't know the answers to these questions and obviously the whole subject is very confusing. All I know is that I will die someday no matter what, and I feel my life with hormones is better with them than without. The hot flashes were manageable, the rest of my body-wide symptoms are not. I can't live my life anymore due to risk of dying based on statistics.
By the way, my estradiol blood level after 3 yrs of only vagifem was 5 pg/ml which seems to explain my symptoms and lessened my fear of taking hormones. Even with patches, my levels never peak to the level of the manufacturer's studies for a given dose.
Sorry this was so long....just some of my thoughts on the matter! It would be interesting to hear what you and others think. I joined this forum because it is very difficult to discuss these matters anywhere else....it is such a taboo subject and most women aren't nearly as informed as you gals on menopause matters!
