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KEY Q&A
The menopausal symptoms I'm experiencing since my ovaries were removed are worse than expected. Why?
The abrupt decrease in hormone levels for women who have surgical menopause can cause more severe symptoms than natural menopause. Talk to your health care professional about medications and lifestyle changes that can ease those symptoms.
I've heard that estrogen can affect my chances of getting osteoporosis. How?
Estrogen helps reduce the rate of bone loss that occurs during normal bone remodeling. Normally there is a balance in the activity of the cells that break down bone and the cells that build it back up. By decreasing the activity of the cells that break down bone, estrogen allows the cells that build bone to have a greater overall effect.Once estrogen levels drop, this balance shifts.
While hormone therapy has been shown to decrease hip and vertebral fractures, it may also increase your risk of other health conditions, such as invasive breast cancer, stroke and blood clots. Discuss the risks and benefits of available treatments with your health care professional.
What sort of side effects can I expect when taking estrogen?
The most common side effects are breast tenderness, water retention and uterine bleeding.
How does hormone therapy affect breast cancer risk?
Some studies suggest a slightly increased risk of breast cancer in women using estrogen. The risk appears higher in women taking estrogen-progestin therapy.
The latest study on the link between breast cancer and ET was published in the Journal of the American Medical Association in April 2006; findings show that women with a history of hysterectomy do not have an increased risk of breast cancer for at least seven years after starting ET. In contrast, findings from the estrogen plus progestin study show that women with a uterus who took estrogen and progestin at the same time had an increased risk of breast cancer at or before five years. These findings show that for women who have had a hysterectomy, ET is safer with regards to breast cancer risk than HT in the short term.
How does estrogen affect cardiovascular health?
Contrary to earlier hormone therapy studies, recent findings from the Women's Health Initiative (WHI) showed that estrogen-progestin therapy initiated in older women does not protect against heart disease; in fact, the WHI showed that one form of hormone, sold as Prempro, when prescribed to healthy older women (average age 65) to prevent heart disease actually increased their risk for the disease in the first year or two of use.
What is known about the benefits of hormone therapy on bone health?
Postmenopausal osteoporosis is characterized by decreased bone mass, deterioration of bone architecture and high bone fragility, making bone fractures of great concern. Estrogen deficiency is the most common risk factor for osteoporosis in women.
Estrogen, with and without progestin, has been shown to be a protective and effective prevention measure against osteoporosis.
