Do you really understand hormone replacement therapy and whether it could be right for you? If you are a woman, deciding whether or not to take estrogen at the time of menopause is not a throw-away choice. It’s one of the most important decisions you will make that will affect your health for the rest of your life, according to Dr. Mache Seibel, MD, a global leader in women’s wellness and menopause.
Based on his research, including personal conversations with researchers around the world, Seibel believes that for most women, the correct question is not “Should I take HRT?”
The question is “When is the right time for me to start estrogen therapy to protect my health, or is it already too late?”
Hormones are chemical messengers that carry instructions from the brain to organs and systems throughout your body. Estrogen is often referred to as a woman’s sex hormone because it plays a significant role in sexual function and childbearing.
In addition to your uterus, estrogen affects many other aspects of your health including your heart, brain, bones and skin. So deciding for or against HRT is more than a question of reproductive or sexual health. It’s a decision that affects your whole body.
If you’ve been considering HRT, you’ve probably come across references to the Women’s Health Initiative or WHI study. That research changed the history of women’s medicine. When the results were first published in 2002, the study appeared to show that the risks outweighed the potential benefits. (1, 2)
The 2002 WHI report still dictates many women’s response to HRT over 14 years later, despite more recent studies and re-evaluations of the 2002 WHI data that offer different conclusions.
One key aspect not considered in the initial WHI report was the timing of when HRT was started relative to the start of menopause. Women receiving estrogen in the study were typically between age 60 and 79 with many suffering from other health complaints, while women in the control group who received placebo were largely in their 50s and in good health. (1, 2)
Re-evaluations of the study data show that women who started taking estrogen early in menopause did not demonstrate the same increased risks as the older women in the WHI study. To the contrary, younger women were revealed to be more likely to gain significant health benefits from HRT early in menopause.
Further examination of the data agreed with the initial reports that older women who start HRT 10 years or more after menopause may experience increased health risks with few benefits other than reducing menopausal symptoms.
Seibel calls the optimum time to start HRT the “estrogen window.” He believes this new understanding of the data from the WHI study can help women make more informed choices about HRT and become a partner in their healthcare.
Seibel and other researchers believe the estrogen window is significant because it offers women relief from symptoms of menopause as well as providing potential protection to body systems that suffer when estrogen declines. (3, 5)
In a review published in December, 2014 in The Obstetrician & Gynaecologist, the authors pointed out the discrepancy between potential risks for older women receiving HRT years after the onset of menopause, and potential benefits for younger women who are within 10 years of menopause. (4)
Seibel expressed concern over women who are worried and confused by conflicting reports and who decide that doing nothing is the safer option. He said, “If they understood what they didn’t know, they would understand how wrong that statement was.”
The decision whether or not to take HRT depends on many factors and personal health issues. But in general, Seibel said, “It’s possible that estrogen can lower their risk of heart disease, osteoporosis, dementia, even breast cancer and many other conditions and most women and many of their doctors don’t realize it.”
He further explained that the physical changes associated with menopause and decreased estrogen may not be immediately obvious, calling them “things that slowly creep up a day at a time and are cumulative so women don’t realize that they are at a different place than they were 10 years ago.”
Seibel believes that understanding the estrogen window will empower women to make better decisions for their health by revealing the optimum times to start and stop taking HRT. Women who are already in menopause can also use the concept of the estrogen window as a tool to help them know whether they have waited until it is too late to safely start treatment. If that is the case, there are other things that they can be doing to be more proactive about their health.
Seibel said, “Women are making decisions today that are going to affect them for the rest of their lives. Women are living past 80 routinely. They are going to live a third of their lives after menopause and they want to be healthy and vibrant and effective at work and available for their loved ones for as long as they can. This is one of the ways most women can help ensure that can happen.”
Current guidelines for HRT recommend that women use the smallest effective dose for the shortest time to accomplish their goals. (6)
If you have questions about menopause and whether hormone replacement therapy is right for you, talk to your health care provider. If you are wondering if you are approaching or in menopause and nearing your estrogen window, visit MenopauseQuiz.com and find out.
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” will be available April 12, 2016. Preorder options and bonuses are available now until April 15th on Dr. Seibel’s website at http://www.estrogenwindowbook.com/
Reviewed April 4, 2016
by Michele Blacksberg RN
Edited by Jody Smith