Estrogen may be the most misunderstood medication on the planet.
Here is the latest example…and this time you can do something about it and prevent a huge disservice to women.
Have you heard of the USPSTF or the US Preventive Services Task Force?
They recommend standards for treating chronic conditions. For the next few weeks they are asking for public comment on their recent draft position about the use of hormone therapy (HT) for chronic conditions.
This is important because Menopause is a chronic condition and while recommendations made by the USPSTF don’t prevent the use of certain medications, they influence use and coverage by insurance companies.
Here’s the background. In 2012 the USPSTF wrote a position paper recommending not using hormone therapy (HT) to prevent chronic disease. A lot of new data has been reported since then that disproves their 2012 position.
But the just released USPSTF draft position continues to uphold its previous 2012 recommendation against using hormone therapy (HT) to prevent chronic conditions, including either estrogen alone or combined with progestin for the treatment of chronic conditions.
And they are asking the public for feedback on this decision…
That’s where you can come in.
Their May 16, 2017 press release quoted task force member Maureen G Phipps, MD, MPH as saying, “The benefits of using menopausal hormone therapy to prevent chronic conditions like heart disease and diabetes do not outweigh the harms in women who have gone through menopause.”
They cite many risks that are now disproved, such as an increased risk of heart disease, breast cancer, and dementia. As I explain in my best selling book, The Estrogen Window, HT isn’t unsafe; the timing of when HT is started in relation to the beginning of menopause determines its safety and ability to prevent conditions. The decision of whether or not to use HT must be individualized for each patient.
A blanket recommendation against HT for chronic conditions is a huge disservice to women!
The flawed original 2002 study called the Women’s Health Initiative or WHI did find an increased risk of breast cancer, heart disease and dementia in HT users. But here’s the facts you need to know….
That study used only one from of estrogen – PremPro, which is contains the estrogen Premarin combined with a synthetic progesterone called Provera. When that same WHI study was reanalyzed in 2013 by matching up the age of the women and the age at which they began taking HT, everything changed.
Almost all of the risks went away and some risks were lower in the treatment group…as long as the estrogen was started within 10 years of the start of menopause or between the ages of 50-59. That’s what I call the Estrogen Window.
And in subsequent WHI studies, for women who began estrogen only in their Estrogen Window, (they had a hysterectomy and didn’t require a progesterone-type medication),
…the risk of breast cancer was 23% LESS than women who took a placebo…
The risk of heart disease was 32% LESS than women who took a placebo…
And there was a REDUCTION in colon cancer, type 2 diabetes and osteoporosis. In fact, the FDA has approved HT for use in women at increased risk of osteoporosis and fractures.
Sounds like prevention, doesn’t it?
It is!
Here’s what I’ve learned after speaking to groups of women all across the United States as part of my Estrogen Window book tour.
Many women are afraid of HT or confused about it because they haven’t heard this newer information. And it’s no wonder. A March 2016 article in the New England Journal of Medicine reported that the number of women on HT was 80% lower today than it was in 2002 when the first WHI paper was reported due to fear and confusion about HT.
And because so many fewer women are taking HT, many doctors, particularly those who completed their training in the past 15 years, the New England Journal article states, did not received adequate training in either menopause or HT and don’t feel comfortable treating midlife women with HT.
So the benefits keep getting overlooked and the myths keep getting perpetuated.
And myths and fears die hard.
And a generation of women have had to tough it out instead of being able to figure it out.
Poorer quality of life; more challenges at work; more fear and confusion; more difficulty with sex and intimacy; more chronic conditions. One article published in the American Journal of Public Health reported that an estimated 45,000 women died prematurely of heart disease because they did NOT take HT. In that study the form of HT was estrogen only.
And there are many women, particularly the elderly, who benefit from local vaginal estrogen to prevent vaginal dryness, painful sex, and chronic urinary tract infections resulting from the chronic condition of genitourinary syndrome of menopause. And chronic UTIs can be lethal in the elderly population.
I’m not suggesting that all forms of HT for all women as a preventive medicine is appropriate. It isn’t. But neither is excluding all forms of HT from their preventive list, such as estrogen alone and local estrogen, which the data support as possessing preventive qualities in menopausal women who go through early menopause or are who begin HT between the ages of 50-59.
The USPSTF does a lot of good. But for HT, I hope they will reconsider their draft recommendation. I urge you to contact them now to voice your opinion during this request for public comment.
Here is the link to comment on USPSTF site by June 12.
