Menopause is a natural occurring event that all women will experience, usually in their early 50’s, when their ovaries cease producing estrogen. Post-menopause is diagnosed when a woman has not menstruated for one year and marks the end of the reproductive period of her life. Gunn Center of Fullerton, CA offers some interesting and useful information on menopause and hormone therapy.
Peri-menopause is diagnosed when the menstrual cycles vary in frequency and length and may be associated with psychological, emotional and/or physical symptoms (discussed later). These disturbances are due to a declining ovarian production of estrogen, progesterone and testosterone that may be periodic or continuous. Women born prior to the 1930’s had a life expectancy of about 50 yrs. Today, a woman can expect to live well into her 80’s with over one-third of her life occurring after menopause and be subject to the physical changes discussed later in this paper.
The history of hormone replacement in women has seen many swings in popularity over the past few decades. In 1991 the National Institutes of Health (N.I.H.) launched the Women’s Health Initiative (WHI) study involving about 161,000 healthy postmenopausal women aged 50-79 years with an average age of 63 years. The study was designed to test the effects of hormone therapy on heart disease, bone fractures, breast cancer and colon cancer. One group of women who had undergone a hysterectomy received oral estrogen (Premarin) alone [estrogen replacement therapy or ERT]. A second group received a combination of Premarin and progesterone (PremPro) [combination hormone replacement therapy or HRT]. A third group received a placebo, which contained no hormone. In 2002 the study was stopped because the Provera group was associated with a slight increase in the incidence of breast cancer, heart attack, stroke and blood clots.
Millions of women in the U.S. stopped their hormone out of fear and they entered into “hot-flash hell”. A recent careful re-analysis and follow up review of the data has revealed that the actual risks of breast cancer, stroke and heart disease were NOT increased over time and were, in fact decreased; especially in women who were perimenapausal when they initiated hormone therapy.
In April 2011 the Journal of the American Medical Association (JAMA) published a follow-up study of the women in the WHI who took estrogen alone. The finding: a statistically significant reduction in breast cancer over time. Further, those women who did develop breast cancer were 63% less likely to die from their disease. Among the women with a prior hysterectomy treated with estrogen alone and followed for 11 years, there was NO increased risk of heart attack, stroke, blood clots, hip fracture, colon cancer or mortality. Importantly, there was a persistent decrease in the risk of breast cancer. This finding is now contrary to the persistently held belief that estrogen causes breast cancer and increases the risk of heart attacks.
After a decade of fear and confusion regarding the risks and benefits of estrogen replacement therapy, medical studies have now clearly established its safety and its health benefits. In March 2012 the North American Menopause Society released a statement that supports these findings, stating that combination hormone therapy (both estrogen and progesterone) initiated around the time of menopause is safe.
Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.
Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.