Do you care about protecting your bones, heart, brain and other parts of your body as you age? It sounds like a stupid question. But many women – whether as an informed choice or due to a lack of understanding or fear – are turning away from a treatment that could potentially help their bodies function better as they age.
The source of that fear and confusion is estrogen, or more specifically, hormone replacement therapy (HRT) that includes estrogen.
According to Dr. Mache Seibel, MD, a global leader in women’s wellness and menopause, there was a time when estrogen was the most-prescribed drug in the United States.
Then came 2002 and the first reported results from the Women’s Health Initiative (WHI) study. Frightened by the WHI report that warned of increased risks of breast cancer and other serious diseases, women around the world stopped taking HRT.
A collaborative study that included researchers from Columbia University focused on the prevention of disease after menopause. According to that study, HRT use declined by as much as 66 percent in the United States following the WHI report. (5)
Seibel, author of the #1 national bestseller The Estrogen Window, believes that avoiding estrogen replacement can lead to serious health problems for many women, as their estrogen levels naturally decrease at menopause. This is especially concerning because Seibel believes many women who decline HRT are still doing so based on out-of-date information and the poor interpretations of the original WHI study data.
The Columbia University researchers said, “Although the most recent publications from the follow-up studies of the Women’s Health Initiative do not recommend menopause hormonal therapy as a prevention strategy, these conclusions may not be fully valid for midlife women, on the basis of the existing data.” (5)
Estrogen is thought of by many people as a woman’s sex hormone. But the effects of estrogen don’t stop with the reproductive system. Estrogen also plays an important role in many other critical systems in the body.
Loss of estrogen at menopause can contribute to serious health risks including:
Estrogen stimulates nerves and affects the neural transmitters that pass signals from one brain cell to the next. Estrogen also protects neurons in the brain from low blood flow, low blood sugar and damage from amyloid protein. This protein is believed to be a key component in nerve damage in the brain that leads to Alzheimer’s disease.
When estrogen levels are low the brain is less effective, which may lead to confused thinking or early signs of dementia.
This is especially true for women who go into early menopause, which Seibel defines as before age 45. He says these women may be 70 percent more likely to develop dementia without estrogen replacement.
Research shows that heart disease is the number one cause of death for women over age 65, and is the second leading cause of death for women ages 45 to 64, according to the CDC.
Younger women tend to be at lower risk of heart attack. But within 10 years after menopause, when estrogen levels drop, women in general catch up with men and have about the same risk of having a heart attack.
The Columbia University authors said, “When initiated in women <60 years old and/or <10 years since menopause, the benefits of MHT [menopausal hormone therapy] outweigh the risks, as MHT statistically significantly reduces CHD [coronary heart disease] and all-cause mortality.” (5)
Research also shows that before menopause, women tend to have better cholesterol levels than men of the same age. But after menopause, less estrogen leads women to have more bad (LDL) cholesterol and less good (HDL) cholesterol than men their age. This also affects heart and blood vessel health, as excess LDL can build up on walls of blood vessels and cause life-threatening blockages.
Our bones use estrogen to make the best use of calcium. Estrogen receptors on bone cells are activated when estrogen is present. These cells can then use calcium to fill in small cracks in bone and make bones stronger. When estrogen is missing, bones can become weaker and break more easily.
Estrogen helps support collagen levels in the skin. Estrogen also affects skin thickness, moisture and the formation of wrinkles. Loss of estrogen can lead to dry, wrinkled skin and skin that looks aged. (4)
Many women today decline HRT out of fear of breast cancer. But re-evaluation of the WHI study now suggests that the WHI report did not clearly represent what the data revealed.
Seibel said, “The WHI reported their data accurately. They just interpreted it poorly and set the study design up so it was destined to be well-intended but misguided. It caused what I call myth-understanding – myths about estrogen that weren’t accurate.”
“In short, the three original reasons for terminating the CEE/ MPA trial, an increased risk of breast cancer, an increased risk of CHD, and an adverse ‘global index’ were not valid. Moreover, the best evidence suggests that the use of unopposed estrogen does not increase the risk of breast cancer and may even reduce it,” said the Columbia University researchers.
Unopposed estrogen is estrogen taken alone, without progestin and is used for women who don't have a uterus. This treatment is not considered appropriate for women who still have their uterus.
As with all medical treatments, Seibel says every woman should discuss her own situation with her doctor to determine whether HRT is right for her personal health. He emphasizes the importance for every woman to be informed about the potential benefits and risks of HRT in order to make the best decision for her health.
Seibel also emphasizes the importance of making a timely decision. He believes that starting hormone replacement at the right time relative to the start of menopause is the key to gaining the most benefit and limiting risks from HRT.
About Dr. Seibel’s Book:
In his new book “The Estrogen Window,” Dr. Seibel presents groundbreaking research which explains that every woman has a window of opportunity to begin estrogen replacement. This critically acclaimed book clears the confusion and provides easy to understand facts and tips to help women decide whether estrogen replacement is right for them.
The book also discusses the safest time to take estrogen to reduce significant health risks, which estrogens and progestogens are safest, how long estrogen should be taken, and how to talk to your doctor about hormone therapy to decide what is best for you.
“The Estrogen Window” is available on amazon.com and through Dr. Seibel’s website at http://www.estrogenwindowbook.com/
Reviewed April 13, 2016
by Michele Blacksberg RN
Edited by Jody Smith
1) Interview with Dr. Mache Seibel. March 16, 2016.
2) Seibel, Dr. Mache. (2016). <em>The Estrogen Window.</em>, New York, NY: Rodale.
3) Estrogen & Hormones. Cleveland Clinic. Web. Retrieved April 11, 2016.
4) Hormones and Your Skin. The International Dermal Institute. Dr. Claudia Aguirre. Web. April 11, 2016.
5) Prevention of disease after menopause. R.A. Lobo, et al. Climacteric. Web. Retrieved April 13, 2016. P 545 & 549.