The estrogen therapy controversy has not been put to rest yet. The WHI study that was highly publicized showed that postmenopausal women who took estrogen did not benefit from the estrogen replacement therapy and may even be at an increased risk of having heart disease.
In 1994, the Women Health Initiative trial using estrogen alone showed no adverse effect from the estrogen therapy. That study was stopped prematurely.
A study published by Manson and her colleagues in the most recent New England Journal of Medicine showed that estrogen therapy in younger women (50 -59 years), who have recently undergone hysterectomy with removal of their ovaries and hence have had surgical menopause, have protection against heart disease by keeping the lumen of the blood vessels open. Without the estrogen, calcium is deposited in the walls of the blood vessels thus causing narrowing.
The take home message is that in women who have had hysterectomy with removal of their ovaries in their 40’s to early 50’s, estrogen replacement therapy may be beneficial to the heart as it slows down the narrowing of the blood vessels.
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