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    Tuesday, February 14, 2006

    Cat Fight: The battle of the estrogens heats up. After telling patients for the past couple of years that estrogen could harm their hearts, a new study says it might help their hearts:

    Estrogen does not increase the risk of heart disease for women in their 50s and may even be protective, according to an analysis of a 2002 study that led millions of women to discontinue hormone replacement therapy after menopause.

    It's actually not a new study. It's a re-examination of the data of the old study, but this time focusing on younger women - those ages 50-59, rather than women of all ages. Which is why, on the same day, we also get headlines like this:

    Estrogen Replacement Therapy Doesn't Protect Heart

    Older women who use estrogen replacement therapy (ERT) following a hysterectomy have about the same risk for heart disease as women who don't use the hormone.

    The key difference between the two is the age of their subjects. As mentioned many times before on this blog, aging is the number one risk factor for heart disease. The risk from taking estrogen is miniscule compared to the risk of getting old.

    posted by Sydney on 2/14/2006 08:39:00 AM 4 comments


    What bugs me about all these studies is that nobody considers women under 50. There are some of us on HRT who are in our 40s, some in our 30s and even some in our 20s.
    If the benefit may be slightly greater than risk for 50-year olds, isn't it logical to assume that it is even higher for younger women - who because of their early menopause are at higher risk of heart deasese. Yet while all (!) UK website clearly make a distinction of under-50/over-59 women, 99% of US website write "low dose for shortest time" while completely ignoring those of us who is way too young to be without hormones.
    "shortest time" is ridiculous for a really young woman. She isn't going to turn 50 in 2 months...

    By Anonymous Anonymous, at 12:46 PM  

    I'm another one bugged by these studies. There is little importance placed on the fact that all these studies used Premarin or PremPro, and as such were not using chemically identical hormones...and the impact that fact could well have on increasing risk factors (not to mention that risk factor increase was marginal anyway). NOR were the study particpants using more than one type of estrogen, as well as progesterone, and testosterone. NOR was the type of hormone therapy being used based on an ongoing monitoring of hormone levels!

    I'd like to see similar studies done using bioidentical hormones. I'd bet the farm that dramatically different conclusions would be reached.

    I think this one-sided reporting of HRT benefits is a real disservice to women and the medical profession.

    By Anonymous Kathy (a nurse), at 12:58 PM  

    One of my major peeves about the medical publication system is the incredible pressure to meta-analyze the study. Especially these long term studies. I completely understand the ethical responsibility of researchers to halt a potentially harmful study early, but analysis for analysis sake is really a type 1 error. When the final results are conflicting, the earlier release confuses patients and practitioners alike. HRT is bad, HRT is good for some, Low-fat diet helps, low-fat diet doesn't help.

    It's no wonder patients in this country are often loathe to be compliant with their doctors' advice on "hot button" health issues.

    By Blogger Caltechgirl, at 1:57 PM  

    All I can say, it's about damn time. I spent hours and hours worth of time trying to explain to younger women suffering from menopausal symptoms that the study did not apply to them and that looking at the perimenopausal group- the ones that may need estrogen the most- might yield better news.

    By Anonymous dani, at 8:20 PM  

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