The High Cost of 10 Years Without Hormones

I went on a rant (in another blog) about one ago.  WHY??? Because in 2002, women were told to get off their hormone replacement therapy because of a position statement surfacing out of the WHI study with skewed  evidence that hormones caused cancer and they were bad for women.  I read the study and saw the bullet holes all throughout it.  Even the highly esteemed Dr. Dobson made a plea to re-evaluate the evidence.  I have that document in my office to this day btw. Things just didn't match up.  Here's why. The women were much older in the study and well beyond the storms of the menopausal years, and they were not looking into cardiovascular, osteoporosis, general health, cognitive, and other needs, ..... just cancer.  That study was OVERTURNED 10 years later and it hit the national news.  Guess what???   They said, we relooked at this, and actually, hormones are good for women if there are not other contraindications or risks preventing their use in an individual.  They went back to the study and looked closer.   The study used SYNTHETIC hormones derived from horse URINE (Premarin) and not bio-identical therapies which match what the body normally produces.  Those types of hormones do have an increased risk of cancer  because they come from non-natural sources. Unless, of course, you consider horse urine to be natural.  Ick!!   I pitched a FIT FIT FIT around here.  My staff can tell you.  I said, WHAT ABOUT THE YEARS LOST for these women?  They have been without hormone therapy for 10 years because of this!!    I'm pretty passionate about what I do if you can't tell.   I've seen the benefits in hundreds of patients throughout the years.  And, I read like a madwoman to try to stay abreast of all that is happening in this growing niche of health and wellness.  I'm a bio-identical hormone user myself.  'nuf said!

 

......Well, this just OUT!  We are now seeing attention given to the evidence that this was bad advice for women.    This is now why women are seeking help in practitioners offices all across America and abroad to get help.  It's grown tremendously in the last 5 years especially.  Cardiovascular disease is the most prevalent risk for women (not cancer) and those women without hormone replacement therapy for all of those years are now statistics in this most current study.   At least ~20,000 are dead and perhaps as many as 90,000 due to heart disease as they look retrospectively at this decision.  Sad!

 

Philip M. Sarrel, Valentine Y. Njike, Valentina Vinante, and David L. Katz. (2013). The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. American Journal of Public Health. e-View Ahead of Print.    doi 10.2105/AJPH.2013.301295

Accepted on: Feb 18, 2013

 

The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years

Philip M. Sarrel, MD, Valentine Y. Njike, MD, MPH, Valentina Vinante, MD, and David L. Katz, MD, MPH

At the time of the study, Philip M. Sarrel was with the Departments of Obstetrics and Gynecology and Psychiatry, Yale University School of Medicine, New Haven, CT. David L. Katz was with the Prevention Research Center, Yale University School of Public Health, Griffin Hospital, Derby, CT; and with the Department of Medicine, Yale University School of Medicine. Valentine Y. Njike was with the Prevention Research Center, Yale University School of Public Health. Valentina Vinante was with the Departemento di Sanita Pubblica, Universita di Firenze, Florence, Italy.

Correspondence should be sent to Philip M. Sarrel, MD, Emeritus Professor, Yale-Griffin Prevention Research Center, 130 Division St., Derby, CT 06418 (e-mail: philip.sarrel@yale.edu). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.

Contributors

P. M. Sarrel directed the literature search and assessment, and wrote the primary draft of the article. P. M. Sarrel and V. Y. Njike acquired the data. V. Y. Njike analyzed the data and developed the data tables. V. Vinante conducted the literature search. D. L. Katz developed the MTEA formula, reviewed and edited drafts of the article. All authors participated in data interpretation and critical article review.

ABSTRACT

Objectives. We examined the effect of estrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years.

Methods. We derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women’s Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in estrogen use observed between 2002 and 2011.
Results. Over a 10-year span, starting in 2002, a minimum of 18 601 and as many as 91 610 postmenopausal women died prematurely because of the avoidance of estrogen therapy (ET).

Conclusions. ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality, but estrogen use in this population is low and continuing to fall. Our data indicate an associated annual mortality toll in the thousands of women aged 50 to 59 years. Informed discussion between these women and their health care providers about the effects of ET is a matter of considerable urgency. (Am J Public Health. Published online ahead of print July 18, 2013: e1-e6. doi:10.2105/AJPH.2013.301295)