While I was studying for my North American Menopause Society Certification last summer I came upon Estrogen Matters by Bluming and Tavris, and fell in love. It’s a well written, easy to read book, by an expert of breast cancer and HRT.
I get asked, almost daily, is HRT safe? Does estrogen cause breast cancer? Can breast cancer survivors take estrogen? Is estrogen safe if you have a family history of cardiovascular disease? Then, during a recent visit, a patient asked if I would write a blog she could forward to her girlfriends in perimenopause to help them understand the safety of HRT.
I decided to answer these most common questions and introduce readers to this book in case they want to do more study on their own. Keep an eye out for Part 2, where I’ll answer more common questions, and Part 3, where I’ll be diving into heart health and menopause.
Recap of Estrogen Matters
Scientists first began studying the effects of estrogen in the 1940s. Since then, hormone replacement therapy (HRT) has been proven in countless studies as the most effective treatment for hot flashes, night sweats, vaginal dryness, and other symptoms of menopause.
Then a study in 2002 by the Women’s Health Initiative (WHI) misinterpreted data and showed an increase in breast cancer diagnoses among women taking HRT. Hundreds of thousands of women, supported by their physicians, immediately stopped hormone replacement therapy. This treatment immediately fell out of favor.
Over time, further study has indicated that the WHI’s claims were exaggerated, misleading, and outright false. But the damage has been done. Over twenty years after these false claims became widely known, many physicians and women still rely on this faulty interpretation of the report to opt out of hormone replacement therapy.
In Estrogen Matters, Avrum Bluming, a medical oncologist, and Carol Tavris, a social psychologist, present “a compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health.”
What Does Estrogen Do for You?
When we enter into menopause, our ovaries stop producing estrogen and progesterone, leading to a state of hormone fluctuation initially and eventual deprivation. During early perimenopause,you’ll have high and low estrogen days, often leading to headaches and mood changes. And by the time you reach full menopause (roughly four to seven years later), your ovaries stop producing estrogen and progesterone entirely.
This decline in hormones may lead to:
- Hot flashes
- Night sweats
- Insomnia / difficulty sleeping
- Difficulty concentrating
- Impaired memory
- Decreased energy
- Bladder and urinary discomfort
- More frequent urinary tract infections
- Increased vaginal dryness, discharge, and bleeding
- Loss of sexual desire
- Painful intercourse
- Depression / sadness
- Tension / nervousness
- Bloating
- Swelling of hands and feet
- Breast tenderness
- Aching joints
- Thinning hair
- Dry eyes
- Palpitations
- Chest pain with exertion
If that sounds like a lot, that’s because it is. Estrogen, and other hormones, are extremely important in helping you feel like yourself and maintain your health.
For example, estrogen helps with a faster resting metabolic rate, making it easier to maintain a healthy weight. Low estrogen makes it more likely for us to gain fat around our abdominal area, which increases the risk of heart disease and diabetes. Additionally, low estrogen affects our microbiome diversity in both our gut and our vaginal tract.
Hormone replacement therapy is the most effective means of replacing and stabilizing hormone levels and managing these symptoms of perimenopause and menopause.
Many women experiencing these symptoms immediately call their OB/GYN, which isn’t necessarily the best option. You need a NAMS certified practitioner who can walk you through your options to find the right care for you. In most cases, that course of action involves hormone replacement therapy, but there is a lot of fear and misinformation floating around about HRT.
As a strong supporter of hormone replacement therapy, I want to dispel three questions I am most frequently asked about estrogen, which are covered in depth in Estrogen Matters.
Does estrogen cause breast cancer?
In short, no. Numerous studies throughout the 1980s and 1990s led to a litany of positive findings, which allowed major journals, research institutions, and oncologists to conclude in 2000 that estrogen does not increase the risk of breast cancer.
In fact, studies have shown that women who received a breast cancer diagnosis while taking hormone replacement therapy fared better than women who were not taking HRT when they received the diagnosis.
Can breast cancer survivors take estrogen?
Yes, even women who have had breast cancer can experience the benefits of HRT. This assertion is backed by nearly three decades of research and studies conducted by Dr. Bluming and a broad range of experts around the world.
Beginning in the 1990s, Dr. Bluming looked at studies regarding the effects of removing ovaries in premenopausal women diagnosed with breast cancer (decreased estrogen) and women who became pregnant after having breast cancer (increased estrogen), and found that neither group experienced significant benefits or higher rates of recurrence.
He then conducted a small clinical trial to determine whether breast cancer survivors receiving HRT to manage menopause symptoms showed an increased recurrence of breast cancer. They did not. Additional studies throughout the US and the rest of the world showed similar results.
Therefore, the best advice is to schedule an appointment with a qualified practitioner so you can educate yourself on the potential risks and benefits and make the decision that is best for you.
Is estrogen safe if you have a family history of cardiovascular disease?
Yes. Studies have long tracked the cardiovascular benefits of estrogen in menopausal and postmenopausal women. Estrogen, when begun early in menopause, has been shown to promote healthy blood vessels and may reduce or delay the formation of plaque.
Heart disease is the leading cause of death in American women. In fact, seven times more women die of heart disease annually than die of breast cancer. Yet, most women fear cancer (particularly breast cancer) and remain unaware of the risks of heart disease. This could be in part because most heart disease studies have focused on men, which means fewer people are aware of the different symptoms that heart disease presents in women.
Numerous studies found that when begun prior to age 60 or within 10 years of the onset of menopause, HRT reduces the risk of coronary artery disease. Further, the benefits of postmenopausal estrogen use outweighed the risks of continuing estrogen use. In fact, it even gives women nearly four additional years of healthy life.
Still have questions about estrogen and hormone replacement therapy?
As a naturopathic doctor and North American Menopause Society Certified Practitioner (MSCP), I want my patients to play an active part of their care. My job is to look at your whole health and inform you of the risks and benefits of each option available, then answer any questions that you have so you can make the right decision for your life.
While I hope that the above information helps alleviate your fears about estrogen and hormone replacement therapy, I understand that this is a vast topic and you may still have questions. If you want to continue the conversation about hormone replacement therapy, let’s schedule a call. I am more than happy to answer any questions and discuss whether hormone replacement therapy is the right fit for you.
