Dr. Heward explains if a 55-year-old woman who experienced menopause at age 50 should take hormones.
Fascinating question for which we don’t have a definitive answer. The reason it’s interesting is that there is some evidence to suggest that it's better to take hormone replacement therapy at the menopause and never go through a period where you are experiencing estrogen withdrawal. The reason for that is that the disease processes that seem to accelerate in the absence of hormones have a chance to get a foothold, and the estrogen may be less beneficial after a period of time when those disease processes have been progressing.
That said, there is also some evidence to suggest that at any point along the way, estrogen may still be beneficial. The concern is some preparations of estrogen, namely, orally administered estrogen, have a first-pass effect on the liver and, in women who have been without estrogen for a period of time since menopause, there may be atherosclerosis underway which is a bad thing to have if you’re going to take a prothrombic agent like estrogen orally.
That said, you could take a transdermal estrogen and avoid that first-pass effect and, I would guess in the absence of solid data, nobody has studied it, that the protective benefits of estrogen would apply to even women who are many years postmenopausal as long as you take a formulation that avoids that first-pass effect on the liver.
About Dr. Heward, Ph.D.:
Dr. Christopher B. Heward is past-President of Kronos Science Laboratory. His primary responsibility was providing scientific and technical leadership for all laboratory activities. He oversaw the development and implementation of the clinical laboratory testing program; assisted in designing and refining both internally and externally sponsored clinical studies; directed and coordinated diagnostic product research and development; administered laboratory and patient databases; was principal investigator for the Kronos Longitudinal Aging Study (KLAS); and communicated Kronos’ discoveries and advances to lay and scientific audiences via presentations and publications. Dr. Heward’s research interests included healthy aging, endocrinology, oxidative stress, Alzheimer’s disease, prion disease (TSE) and menopause. Dr. Heward attended the University of Arizona and received a Bachelor of Arts degrees from both the Department of Psychology and the Department of Chemistry, as well as a Bachelor of Science degree from the Department of Biology. He earned his PhD from the Department of Biology in 1981.
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