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Dr. Friedman’s Guide to Estrogen Replacement

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There are risks and benefits with all medicines, and estrogen replacement is no exception. In fact, estrogen replacement is one of the most controversial topics in endocrinology. This is due to conflicting data on its benefits and side effects, the multitude of available hormone replacement products and regimens and the fact that most studies on estrogen replacement have been performed using the heavily-marketed
estrogen preparation, Premarin. Because of its complexity, the decision about whether you should be on estrogen replacement, and equally as important, what type of estrogen replacement is correct for you, needs to be carefully thought out by you and your doctor.

Another controversial issue related to estrogen replacement is progesterone replacement. Some information on estrogen/progesterone replacement and the benefits and side effects of some of the available compounds are described below. Patients interested in testosterone replacement are encouraged to read the article available on this Web site
entitled “Testosterone Replacement in Women.”

There are both definite and possible benefits and risks of estrogen. The definite benefits include 1) improvement of menopause symptoms, such as hot flashes, night sweats, vaginal dryness, insomnia, mood swings and depression and 2) increase in bone density leading to prevention of osteoporosis. Possible benefits of estrogen include a decreased likelihood of developing cardiovascular disease, improvement in lipids
(cholesterol), decreased risk of colon and rectal cancer and a prevention of memory loss and cognitive decline. The definite risks of estrogen is endometrial cancer (reduced if progesterone is given along with estrogen) and blood clots. Possible risks include an increase in breast cancer and gallbladder disease.

A recent study (the HERS study) found that estrogen actually caused women who already have heart disease to have more heart problems in the first year of taking estrogen, than women who were not given estrogen. In the additional years of the study, both groups of women had similar incidence of heart problems.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.