One aspect related to that is the age of the subjects.  As reported in the Washington Post, the age of women involved was over 65 – an age when they were well and truly past menopause.   They report there are new trials (ELITE and KEEPS) focusing  B/HRT’s effect on cardiovascular disease in women who have recently reached menopause as well as women 10 years past that milestone.  Of course it will be many years before we know the outcome if indeed any clear outcome is derived.  However simply doing the trials, re-opens the doors for HRT as well as supports the recent trend for BHRT.

A complete version of the article can be found here.

Given many women are seeking B/HRT treatment during perimenopause, it is curious as to why there studies looking at this demographic …

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Touting HRT as “anti-aging” more than a treatment for menopausal symptoms, the report states prior to its bad press in  2002, one-third of American women over 50 were being prescribed combination progestin-estrogen hormone therapy. This subsequently dropped to one-ninth.  Sounds a lot but that still means 20 million American women are on HRT.

So what are the risks?  Breast cancer.  A clear correlation between HRT and breast cancer was established based on breast cancer incident rates before and after 2002.  Clearly, HRT increases the risk of breast cancer. Yet doctors still argue it is not as clear cut as that.  They also say that the risk is still low implying it is worth it given the benefits of HRT. 

According to the report, the recommendation on HRT is:

• lower doses,  .325-mg estrogen and 1.5-mg progestin
• maximum of 2-3 years
• women under 60
• women who are not high risk breast cancer. 

However you rush out to get an Rx for HRT, read about the results of the UK Million Women Study.

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In 2005, Hormone Replacement Therpy (HRT) became a dirty word after studies revealed it could have negative repercussions for some people in regard to cardiovascular disease.  It was considered that that the overall risk was not worth it.  Exit Hormone Replacement Therpy, stage left.

In 2009, at 55, Oprah revealed that she is experiencing menopause and was having a tough time of it.   She revealed that once she dealt with hormonal imbalances using “natural” means, her life became much better.  Enter stage right, bioidentical hormone replacement therapy.

Hormone replacement is not a new issue.  Women who take the pill has been “replacing” their hormones for years.  We simply never considered it that.  We were preventing pregnancy. But we were doing it by playing around with our hormone levels using synthetic/man-made hormones.  

The pill comes in two main forms:

1. Combined meaning it has estrogen 

2. Low Dose meaning progestin-only pill

Until 1998, it was considered unsafe for women over the age of 35 to keep taking the Pill for reasons very similiar to issues relating to HRT – increased risk of stroke,  heart attack and breast cancer. However with the introduction of low-dose pills that risk was significantly reduced and now it is considered safe for women over 35 and even over 40 to keep taking low dose pills provided they do not smoke, not over weight and are generally healthy.  In fact there are considerable benefits to women doing so including dealing the very menopausal symptoms which HRT sought to deal with.

In addition, the abortion rate for women over 40 is second only to the abortion rate or women under 24.  You could say that both groups mistakeningly think they cannot get pregnant – but they do. Without contraception, the annual risk of pregnancy is around 10% for women aged 40-44 and 2-3% for women aged 45-49, and the risk may not be zero for women over 50. In women over 45 years who have not menstruated for one year the probability of subsequent menstruation (which could be ovulatory) is estimated to be 2-10%. There is a clearly established need for contraception until the menopause is established

So all up using a low does pill until Menopause might be the widest thing to do.

But can we do it?  Not really.  Health insurance companies do not like it. 

 http://www.psychologytoday.com/articles/pto-20070117-000002.html

http://www.who.int/reproductive-health/hrp/progress/40/news40_2.en.html

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