The Menopause Minute - Volume 83

When you get sick, you typically take a course of action so you can recover and return back to good health. This behavior should not be limited to illness, but at menopause as well. It's up to you to establish good health habits so you can bounce back easier from illness and the same goes for carrying on through menopause. I hear from many women that they fear menopause. They believe menopause is all about dreadful symptoms that they won't be able to deal with. Some are in the throes of disrupting symptoms, while others seem to learn to deal with them, establishing an "I can handle this" attitude.

For the doubtful, I ask, why not view menopause as a gift? It can be a powerful stimulus to change your health. Many women opt to start yoga classes, make improvements in their diets, have regular massages, and this helps to somewhat eradicate the stresses that fall upon them at menopause.

This week a study in the Journal of the American Medical Association (JAMA) sheds new light on taking estrogen. Here is what it means to you.

Estrogen versus Estrogen and Progesterone and Uterine Cancer

Like all medications, estrogen is a powerful hormone with benefits and risks that have to be weighed and personalized for each woman. Forty years ago estrogen was so popular and considered so beneficial that almost all women were encouraged to take it from the time of menopause until death. Unfortunately, it was found that estrogen alone can cause cancer of the uterus. Women who have had a hysterectomy and had their uterus removed don’t have this problem.

Then researchers discovered that women who take daily estrogen combined with progesterone for at least 10 days of the month did not get uterine cancer. There were some risks of blood clots and strokes, but overall it was believed that estrogen plus progesterone protected the uterus from uterine cancer and estrogen helped to prevent heart disease. The heart disease part of this changed with more research.

Estrogen and Progesterone and Breast Cancer/Heart Related Illness

Entitled, Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy, this study by the WHI Investigating Group providing on-going analysis after almost 11 years follow-up of women who took oral estrogen (Premarin™) found that indeed their incidence of breast cancer was certainly not higher, but in fact was significantly lower than for women who took no hormone therapy, and that this (small) protection seemed to continue over time, even after they had stopped therapy.

These findings run contrary to the findings that women who consumed Premarin™ plus the potent progestin (synthetic progesterone) medroxyprogesterone (Provera™) experienced a slight increase in breast cancer rate, and that this small increase also appeared to hold over time… Additionally, and of equal and perhaps greater importance (since > 50% of women die of cardiovascular disease), this long-term re-analysis of data showed a parallel diminishment in cardiovascular disease, along with no increase in stroke! Interestingly, it was what initially appeared to be an increase in incidence of stroke that caused the investigators to prematurely stop this part of the study at 7.1 years.

We’re all pretty much used to reading and hearing about all of the different household chemicals that may be causing health concerns in our environment. Now, a new study is placing more focus on how they relate to menopause. The study, published in the Journal of Clinical Endocrinology & Metabolism, was a result of 26,000 West Virginia women whose drinking-water supplies had been contaminated with PFCs from a nearby DuPont plant in 2005 and 2006 and found that women exposed to high levels of perfluorocarbons or PFCs may go through menopause at a younger age than other women.

As part of a lawsuit over water contamination, blood testing was performed in six water districts. On average, area residents' levels of one type of PFC, called PFOA, were 500% higher than the average American's. However, their average level of another PFC, called PFOS, was similar to the U.S. norm. Among women older than 42, the testing found those with higher blood levels of PFOS were more likely to have gone through menopause. They also tended to have lower estrogen levels than other women. Whether PFCs were the cause is not known.