Is HRT Really Safe Again?
Monday July 9, 2007
A new analysis of data from the Women's Health Initiative (WHI) study, published in the New England Journal of Medicine, suggests that in younger post-menopausal women (those from 50 to 59 years of age), hormone replacement therapy (HRT) is associated with a reduction in coronary artery calcium scores. (A lower calcium score correlates with a lower risk of heart attack.) This new information appears to be in contrast to the overall findings of the WHI study, in which HRT was associated with a significantly increased risk of cardiac events.
This new information has proponents of HRT celebrating, as if it proves that HRT is safe in younger women. Unfortunately, it proves no such thing, and anyone considering HRT on the basis of this new study had better make themselves aware of all its implications. For an analysis of the new HRT study and what we can take away from it, look here.
Comments
Dr. Fogoros, While I appreciate your addressing the HRT question, I am curious why studies are based on Estrogen/Progestin (Premarin) rather than Estrogen/Progesterone. I am not an MD.
My understanding is that there is substantial between progesterone (which, as a natural substance cannot be patented by a pharmaceutical company) and progestin. My understanding is that progestin treats *some* symptoms of unopposed estrogen, it does not provide the full range of protection found in progesterone.
My understanding is that compounded HRT uses estrodiol, estriol, progestrone and testosterone, and that levels of each component can be adjusted to the individual’s specific physiology. In addition, estrogen and testosterone, both stimulating hormones, may be administered in the morning, and progesterone, a calming hormone, administered at night. Estriol can be used as a vaginal creme to (1)reduce vaginal dryness and (2)reduce frequent urination and night urination by strengthening the pelvic floor muscles.
I would be curious to hear about similar HRT research using compounded HRT. At minimum, a comparison of Progestin and Progestrone.
Your column has prompted me to contact the WHI directly and ask why the study is based on a progestin-based compound. Again, my thanks for your focus on this important subject.