Women Using Hormone Replacement Therapy Risk Having a Stroke

Dr Francine Grodstein and her colleagues at the Brigham and Women's Hospital and Harvard Medical School collected data on 121,700 women who participated in the Nurses' Health Study from 1976 to 2004. The study looked at the relationship of hormone replacement therapy to the occurrence of stroke. Over the course of the study, 360 women who had never used hormones had stroke compared with 414 women on hormones.

This increased risk was observed in women initiating hormone therapy at young ages or near menopause and at older ages or more than 10 years after menopause." Younger women taking estrogen for less than 5 years had decreased chance of getting stroke. Age is thus a factor in the occurrence of stroke. The take home message is that if you need to take estrogen for menopausal symptoms, take the low dose for less than 5 years. Beyond that, you may be taking the risk of having a stroke.

Reference: NIH NEWS

Estrogen Therapy is good for the Young Postmenopausal Woman’s Heart.

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.

Hormone Replacement Therapy Linked To Ovarian Cancer.

Ovarian cancer is a deadly disease. Up till now there has not been any significant test to screen for the disease in its early stages. The recent finding from a British study that appeared in the Lancet is frightening since its use may have resulted in a thousand deaths since 1991. The study was from the million women study. 30% were current users of hormone replacement therapy and 20% were past users. Current users had 1-2 fold greater risk for ovarian cancer than never user. The highest risk was for serous tumors in women with epithelial cancer, with current users at 1.53 times the risk as never users. The consensus is that current advice to take estrogen replacement therapy will not change however women should take hormone replacement therapy for a short time.