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The
Estrogen Merry-Go-Round
by
The Social Diary Health Columnist Ruth S. Jacobowitz
Column #3, January 10th, 2006
I
can’t believe I’m going to write more about the Women’s
Health Initiative (WHI) and estrogen, but here goes.
Last month I was lecturing on a ship and was scheduled to give
my lecture “The Estrogen Dilemma: What Do We Do
Now?”
Two
days before the scheduled topic, I ran into a friend from the
United Kingdom with whom I’ve sailed before. Her name is
Yvonne. She said, “Boy, am I glad to run
into you before your lecture. I can’t wait to show you what
was in Britain Today.” (Point of explanation: On the ship,
all the Americans have a mini-New York Times delivered to their
staterooms each day and the Brits received their mini publication).
“Don’t
move a muscle,” she said and ran to her stateroom, returning
quickly with the publication. “What do you think of this?”
she asked. I couldn’t believe my eyes. There in black on
white was the vindication I had known would come for, as my friends
are aware, I have always believed that the WHI was seriously flawed
and I have never believed that we needed to change anything we
were doing based on its results.
Before
I quote the article in Britain Today, come back with
me if you will as we chart a brief history of estrogen use. 1966-a
book by a Brooklyn gynecologist, Dr. Robert A. Wilson
entitled “Feminine Forever” promises women
that estrogen is the fountain of youth. 1976-a couple of articles
in the New England Journal of Medicine report a few incidences
of uterine cancer in women who take estrogen. The fountain of
youth dries up! 1980s-scientists figure out that if estrogen is
cycled with progestin each month, as women’s premenopausal
bodies do, the risk of uterine cancer would be avoided and that’s
where we were until the WHI. In fact, during the 80s, 90s, and
even for a couple of years after we crossed the millennium, most
physicians told most women to take estrogen for the rest of their
lives.
The
next big change came about in July, 2002 when the WHI stopped
its arm of the study in which women with an intact uterus took
Prempro—the only estrogen plus progestin product used in
the study. Then in March, 2004, the WHI stopped the estrogen alone
arm of the study. Now the medical wisdom seems to be that it’s
best if women complaining of menopausal symptoms take the lowest
dose of estrogen for the shortest period of time.
Wait
until you hear this. The headline in Yvonne’s article is
“Women May Have Been Mislead on HRT and Heart Disease.”
Then the article goes on to say, and here I quote, “Scientists
said that the Women’s Health Initiative study, which reversed
many experts’ opinion about HRT, could not possibly have
detected a beneficial effect on heart health given the way it
was designed.”
The
article continues, “The new research, led by Dr.
Frederick Naftolin from Yale University, concluded
that the WHI was underpowered by a factor of 10 and would have
had to enroll thousands more participants to have any statistical
relevance.”
Whew!
Finally a challenge to the flawed WHI! Women need to be comfortable
and do whatever contributes to that feel good/look good philosophy
and many women in the US and the UK and elsewhere who quickly
ditched their hormones in the aftermath of the WHI results have
raced back to their estrogen. Now I’m not interested in
encouraging or discouraging the use of estrogen, but as
Jack Webb always said on Dragnet, “Just
the facts, Mam.”
_____________________________________________________
*
Ruth S. Jacobowitz is an award-winning medical writer,
dynamic lecturer, columnist and former vice-president of a teaching
hospital in Cleveland, Ohio. The Estrogen Answer Book,
is her fifth women’s midlife health book. She is also author
of 150 Most-Asked Questions About Menopause; 150 Most-Asked
Questions About Osteoporosis; and 150
Most-Asked Questions About Midlife Sex, Love, and Intimacy.
Her first novel, Final Acts,
a medical/legal thriller was published in September,
2004.
Ruth’s engaging and informative
lectures have taken her all over the world. She educates men and
women about how they age and empowers them to take charge of their
own health. Her books are published in 14 languages. She has been
on 48 Hours, Today, CBS This Morning, Donahue, Leeza,
America’s Talking, Food Television Network, People are Talking
as well as on local television news and talk programs
and in the New York Times, Washington Post, Vanity Fair,
Newsweek, and on National Public Radio.
Visit
Ruth at her website www.ruthjacobowitz.com
.
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