Estrogen Therapy – Is Hormone Therapy Safe? Interview with Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School to learn more about how estrogen therapy can reduce menopausal symptoms.
Estrogen Therapy – Is Hormone Therapy Safe?
I recall hearing about the Women’s Health Initiative (WHI) report and wondering about the safety of estrogen therapy. Many women endure years of uncomfortable symptoms of peri-menopause and menopause without relief due to fear of the potential side effects listed in the report. I interviewed Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University’s medical school to find out more. Dr. Lauren Streicher explains here how when taken at the right time, and in the right way, estrogen therapy can reduce vasomotor symptoms (hot flashes) due to menopause. Women can get their hormone levels tested by their doctors, and some insurances cover hormone therapy. So, relief is possible. Here’s the interview
Lisa LaGrou Oakland County Moms – What happens to a woman’s estrogen and progesterone levels as she ages and approaches menopause?
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – Basically, as a woman starts to approach menopause which is what we call peri-menopause – this is when you have a fluctuation of estrogen levels. They can be up one day and down the next and the only thing we can say that is predicatble about peri-menopause is that it’s unpredictable. Menopause, however, is when someone’s estrogen tank is on empty. They are no longer producing estrogen, their ovaries are out of business, or in some cases their ovaries may be removed surgically. So, at that point, a woman knows that she is no longer going to be making estrogen. The average age at which this occurs in the United States is 51/51.5. But, it can be happening at any time after the age of 40 which is a lot younger than most people appreciate.
Lisa LaGrou Oakland County Moms – If a woman is experiencing hot flashes during peri-menopause/menopause, what is she lacking? Can hormone therapy help?
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – Hot flashes – it’s everyone’s first symptom. 80% of women do experience hot flashes and what most people are completely blindsided by is number one, how severe they can be and how debillatating they can be, and also how long they last. A lot of people say to me, “You know, it’s only going to be a little while. I can tough it out.” When I tell them on average hot flashes last 7-12 years, this is information that they just do not have. And, the other problem is that women just assume that if they maintain a healthy lifestyle, which is all good – eating right, doing yoga…all of those good things – they think that’s going to reduce hot flashes. We know that that is just not the case. Even women who do everything right can still have severe hot flashes, and the best way to eliminate them or reduce them is hormone therapy. It’s the lack of estrogen that makes your body’s thermostat not function. A lot of women also think in terms of progesterone, but that’s really not the critical hormone as far as controlling hot flashes and eliminating hot flashes.
Lisa LaGrou Oakland County Moms – If a woman is experiencing weight gain during peri-menopause/menopause, what is she lacking? Can hormone therapy help?
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – The fact is that women gain weight in mid life. We know that there are a lot of different reasons for that. But the good news is that we know that taking hormone therapy is not going to cause weight gain. A lot of women who otherwise would benefit tell me “I don’t want to take hormones because I’m already struggling with my weight and this is just going to make it worse. We know from scientific studies, from clinical trials, that there is no association with hormone therapy and weight gain.
Lisa LaGrou Oakland County Moms – Ok, that’s surprising. I’ve heard that women lacking progesterone can experience weight gain, and taking hormone supplements can help.
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – Actually, that’s not the case. Progesterone, specifically, is something that occurs when a woman ovulates. The purpose of progesterone for before somebody goes through menopause is really just to get the uterine lining ready for potential pregnancy. After menopause, the reason we give either a natural progesterone or a Progestin is to protect the lining of the uterus so you don’t get an abnormal buildup. But, if you don’t have a uterus, you don’t need to take the Progestin. You can take the estrogren alone in order to alleviate those symptoms. And, taking Progestin will not help you lose weight.
Lisa LaGrou Oakland County Moms – If a woman is experiencing brain fog during peri-menopause/menopause, what is she lacking? Can hormone therapy help?
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – Well, the brain fog comes from a lot of different things, and quite frankly, in a lot of cases it’s from lack of sleep. If you’re not getting at least 6/7 hours of sleep, you can’t function and you can’t think right. We know that absolutely that is one of the things that happens during peri-menopause and menopause. We know that if we give the hormone therapy and it decreases the hot flashes, that in turn is going to help people get a good night’s sleep, which in turn can help alleviate the brain fog.
Lisa LaGrou Oakland County Moms – What are the main risks associated with estrogen therapy?
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – When the WHI (Women’s Health Initiative) study came out in 2002, of course the purpose of that study was to look at risks and health concerns associated with hormone therapy, things like blood clots, cancer, heart disease and dimentia. And what we now appreciate is that in that study there were a lot of different groups of people. There were women who were taking estrogen alone, women who were taking estrogen and Progestin, young women 50’s-60’s, women that were over 60, and the risks and benefits of each one of these groups is very different, which is why we have to individualize therapy and why women really need to talk to their own health care practitioners in order to find out what their potential risks or benefits may be. I also think that it’s really important for women to get information for themselves so when you go for that appointment you already know quite a bit because if you’re armed with information, then you’ll know what questions to ask.
Lisa LaGrou Oakland County Moms – Where can women go to find more information?
Dr Lauren Streicher, Clinical Professor of Obstetrics and Gynecology at Northwestern University Medical School – You can actually read the WHI study. The Women’s Health Initiative study can be found on whi.org. And, the other really good place to go for information is at the North American Menopause Society’s website which is menopause.org, which gives a lot of information, not just about hot flashes and hormone therapy, but menopause in general. It also helps you find a menopause expert because your own doctor may not be an expert in menopause. Not everybody is. And then I have a book “Sex RX: Hormones, Health and Your Best Sex Ever” that does the really deep dive into all of the symptoms surrounding peri-menopause and menopause and ways you can alleviate those bothersome symptoms.