Unanswered Questions

 

Over the last few years, the hormone debate has grown from a stated certainty that the Women’s Health Initiative (WHI) was the definitive answer for estrogen usage and that women should not use estrogen because it causes breast cancer and has no benefits in cardiovascular disease to one of uncertainty. Today, we understand that the WHI was not designed to address younger women entering menopause. This is why we are now stating that it is an “unanswered question.” (For more on the WHI, click here.)

What are hormones? The female sex hormones, estrogen and progesterone, are steroids which are fat-soluble molecules related to cholesterol. Estrogens cause the body to become feminine in appearance at puberty. Estrogens also stimulate the uterine lining, and are required for fertility and normal menstrual cycles. In addition, estrogens help maintain bone mass by preventing calcium loss.

What are the conditions and symptoms of loss of estrogen? They include osteoporosis, heart disease, hot flashes, vaginal dryness, moodiness, sleep interruptions, and change in cognitive function. The symptoms are considered quality of life issues, which are important in your daily life.

What should you know today about estrogen? Many women are seeking other means to improve their quality of life, including natural products, transdermal estrogen (the skin patch) or lifestyle change. There is little research on the efficacy of the natural product estrogens and no large long-term studies on transdermal estrogen. However, the current research on transdermal estrogen indicates it might be safer than oral, although less effective.

What is a woman to do? Just as each of us is unique in the way we look, researchers are now understanding that not only are women different from men, but in the case of HT, we differ from each other as well. The practitioners are attempting to individualize HT care as much as possible.

• Remember to ask your doctor questions if you do not understand. If you are not comfortable and do not know what questions to ask or are nervous during your doctor’s visits, take a friend, family member or tape recorder. This will help you better understand what your options are. When it comes to our health, it is our responsibility to ask questions and communicate as clearly as possible. When you go grocery shopping for that special recipe, you make a list. Consider making a list of questions for your doctor as well.
  
• Learn as much as possible about the medications and health issues concerning you and your family. Remember to consider the source and check references.