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The Estrogen Dilemma: Maybe the best article ever on hormone replacement

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“I started taking estrogen because I thought I was going crazy. Then the studies on hormone replacement really made me nuts. What’s a woman to do?”

If you are in perimenopause or menopause, you know this feeling. Do you or don’t you seek hormone replacement therapy? If so, do you go with synthetic or bio-identical hormones? And do you stay on it for a long time or just use it as a short-term battle plan against hot flashes and other symptoms? Plain and simple, if you have ever asked yourselves any of these questions, you must read Cynthia Gorney’s weekend article in the New York Times magazine.

Gorney tells her own story, first of the puzzling dark “Pit” she would fall into periodically, then of the experience of how her estrogen patches helped pull her out of that pit and gave her her mind back. But she also explores, deeply and relevantly, the science behind estrogen therapy, the conflicting scientific and emotional views of it, her rollercoaster search for answers, and – in laywoman’s terms – the tsunami of hormone replacement research, the 2002 Women’s Health Initiative study that produced so many warnings and so many worries about HRT.

Gorney writes:

“The patches my gynecologist prescribed worked, by the way. I didn’t understand how, beyond the evident quieting of some vicious recurring hormonal hiccup, and neither did the gynecologist. But she had other women who came in sounding like me and then felt better on estrogen, and I would guess many of them, too, decided after the W.H.I. news that they could surely find other ways to manage their “mood swings,” to use the wondrously bland phrasing of the medical texts. (I’m sorry, but only someone who has never experienced one could describe a day of “I would stab everyone I know with a fork if only I could stop weeping long enough to get out of this car” as a “mood swing.”) We muddled along patchless, my mood swings and my patient family and I, until there came a time in 2006 when in the midst of some work stress, intense but not unfamiliar, I found myself in a particularly bad Pit episode and this time unable to pull out.

“It was profoundly scary.

Add a Comment6 Comments

Dear Cynthia:

I just read your 2010 article The Estrogen Dilemma. Thank God for you I do. I just started the bio identical hormone patch two weeks ago. I'm a 13 year breast cancer survivor, a famous one here in Vegas. I ran with the patch! Risks and all.

I was getting so sick a year ago. My husband and I thought I either had breast cancer again (I lost both of them in a double mastectomy on January 17, 2001) or developing a mental illness. We were both scared.

Finally this March 2014 I ended up I the hospital with the doctors thinking I had a TIA mini stroke. It was not. It was a horrible hormone imbalance. It has been hell. But I am happy that I ended up in emergency babbling gibberish like a stroke victim. All the MRIs, CT scan, ultrasound on my chest and EEG to my brain and every other test they could think of for stroke and cancer came back clean. Thank God!

I ran to my own primary care doctor a week later and ordered her to test me for my hormones. I passed with flying colors. My FSH was high and my estrogen was low. I had been body-snatched by the menomonster. It was horror moan time for me. It was hell. Until I ran to my OBGYN the same one who had done my hysterectomy (but left my ovaries) just a month before my chest was whacked off. I had lost track with him due to insurance change and now once again found myself in his office because my insurance included him. He was thrilled to see me. Even letting me cry on him in his arms to release the monster within. I was not crazy or cancer cell consumed. I cried and laughed through my tears of relief.

And yes I begged for the Bio patch. After all he left my ovaries in for 13 some years and they were making more estrogen than the highest patch dose offered. I got the mid-grade 89 octane dose after one week of being on the 87 regular which wasn't enough.

I'm only two weeks on the patch but OMG do I feel like me again until the end of the 3rd day before I change the patch out. The roller coaster ride is a bitch I just can't say it nice but I'm not scared of breast cancer being on it.

We discussed the risk of BC and will worry about if it ever arrives again. I doubt it. I eat healthy. He put me on for only 2 years. You can study me if you like. I also take Schizandra (I've been on it for 13 years for chemo fatigue which it removed and I never went off it then found out last week in Asia that this adaptogen is giving to menopause women all over Asia), Ashawagandha, Maca Root and a few others. They help tremendously alongside the Bios.

Please feel free to contact me. My full story is at www(dot)AREALLIVEPINKBAT(dot)COM it's about my breast cancer and baseball career with the men. You'll love it.



I'm also in culinary school and my mantra right now is NOT THROWING KNIVES and maybe I should write a book that title about this menomonster journey. I have a blog www(dot)AuntWeeniesKitchenKoup(dot)WordPress(dot)com I am working on my professional certification so I can help other cancer survivors to make healthy food choices. We don't learn about good nutrition after cancer. I've lost five dragon boat racing breast cancer teammates to BC again three whom ate horrible junk.

Big hugs from Norine V. aka A Real Live Pink Bat

April 15, 2014 - 3:25pm

The word 'natural' is an interesting word when it comes to drugs. Heroine is natural, by the way. Natural is the buzzword that gets the sale. All natural products also have side-effects although they are milder and fewer than other drugs.

Glenda de Vries

April 30, 2010 - 4:49am
EmpowHER Guest

This a good read and great site! I agree with "Staringat40" - definitely not a lecture. I think that there's a lot of misinformation and half-truths surrounding the risks and benefits of hormone therapy, be it bioidentical or not. A friend of mine at work mentioned that she started using bioidentical hormones and claimed that they were safer because they were natural. I read that they're compounded in pharmacies - how does this make it "natural"?

Does anyone know anything about this?

April 29, 2010 - 8:44pm

Yes, I agree with Holly a.k.a startingat40. We're lectured enough in life, we certainly don't need a lecture at menopause.

All of our womanly functions are unique-from the choices we make whether or not to use painkillers during labor and delivery to whether or not to use hormone replacement therapy at midlife. All of our risks, benefits and tolerances are different and no one should feel bad or guilty because their menopause is harder or easier than someone elses.


April 21, 2010 - 11:05am

This was a great article. It contained alot of information without feeling like a lecture on what you should and shouldn't be doing.

April 21, 2010 - 10:44am
EmpowHER Guest


I just love this article because it describes the unique struggles that women can have with menopause. There's no one shoe fits all for menopausal experience or choice of treatment.

While some women will require hormone therapy, or other medical intervention such as antidepressants etc, other women can do very well just with lifestyle changes, fitness and diet to ease their symptoms.

Glenda de Vries

April 20, 2010 - 1:03pm
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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.


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