Estrogen, Not Bad for Heart Health

Four years after studies discouraged millions of women from using hormone therapy, showing it is bad for health, new research has shown estrogen could actually be beneficial.

Estrogen has proved to be healthy for the heart if taken at or around menopause - when it is actually most needed, to relieve hot flashes. The current Women's Health Initiative study, funded by the government, has also shown that estrogen is harmful only for women who wait until after 60 to take it, when they most probably already have some incipient form of heart disease.

The real risk factors for the heart are smoking, obesity, high blood pressure, while hormone therapy presents only a very small risk.

The findings, published in the Archives of Internal Medicine, are limited to women who take estrogen only; most women take estrogen and progesterone together. However, another study from Women's Health Initiative analyzed the effects of the combination, to reach approximately the same results: women who started taking the hormones close to the beginning of menopause had a slightly lower risk of heart disease.

However, as Dr. JoAnn Manson of Harvard University warned, hormone therapy should not be used for the purpose of preventing heart or cardiovascular disease. Dr. Manson is one of the WHI study's lead investigators.

Two older WHI studies were halted in 2002 and 2004, respectively, after they had found that: (a) - the estrogen and progestin combination caused a few extra heart attacks, strokes and breast cancers (though it prevented some hip fractures and colon cancers);and (b) - women taking estrogen (though women older than 50) had a slightly increased risk of stroke, even there was no difference noted in the risk of heart disease, while the breast cancer risk was lower.

The average woman in these studies was 63 years old, 12 years post-menopause. Researchers then wondered whether these findings stay true fro menopausal women as well (51 years old, on average).

The results of this newer study have shed light on these aspects. The study also shows that women taking estrogen have a significantly lower chance of having a heart attack, bypass surgery, angioplasty or of dying from heart disease, as well as better scores on tests of cholesterol levels and insulin resistance.

However, this study's findings do not address the increased breast cancer risk found in women who took the combined hormone pill. Women can only avoid the risk posed by synthetic progestin in combined pills by having an intrauterine device implanted that contains natural progesterone.

Also, this study does not answer the question of how long it is safe for a woman to take hormone treatment if she starts it around the onset of menopause. Researchers say that the current guidelines for hormone therapy stay basically the same: it is best to use the lowest effective dose of hormones for only as long as it is necessary to treat the symptoms of menopause.

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