This report has been updated with #1320.
A study in the Journal of the American Medical Association shows that postmenopausal women who take both female hormones, estrogen and progesterone, for more than 10 years almost doubles their risk for breast cancer (1). The good news is that taking estrogen for fewer than 5 years does not increase breast cancer risk significantly and that taking estrogen without also taking progesterone increases risk only 1% per year. Furthermore, women who stopped taking estrogen for more than three years were not at increased risk for breast cancer.
Doctors prescribe progesterone only to women who have a uterus. Estrogen stimulates the inner lining of the uterus to grow. Progesterone stops the stimulation. Women who are given only estrogen are six times more likely to suffer uterine cancer because they have a uterus that is stimulated all the time which can lead to uncontrolled growth which is cancer. Women who take estrogen and progesterone suffer almost double chances of getting breast cancer, but they still live longer than those who don't take hormones. Estrogen prevents strokes, heart attacks, osteoporosis, senility, lowered IQ, colon cancer, Alzheimer's disease, loss of teeth hot flushes, dry vagina and depression.
Estrogen prevents osteoporosis, which kills 20% of women when it causes hips to break and causes broken bones, horrible loss of height and severe bone pain. A woman bones are strongest when she is 20. After that, she loses bone strength progressively each year. When she reaches the menopause, the rate of bone loss increases three to five-fold for a few years.
Therefore, here are my recommendations for postmenopausal women: 1) If you do not have a reason to avoid estrogen, such as a strong family history of breast cancer, had breast or uterine cancer, an abnormal Pap smear, or a history of clots, women should take estrogen for up to three to five years. 2) If you have a uterus take progesterone with estrogen. 3) If you should not take estrogen, get a bone density test. If your bone bones are weak, take Fosamax or Raloxifene to strengthen them. 4) A dry vagina can be treated with estrogen vaginal creams up to 3 times a week, frequent intercourse and vaginal lubricants. 5) Hot flushes can be prevented by eating lots of foods containing phytoestrogens such as whole grains, yams and soybeans (2,3,4,5,6,7,8,9,10,11,12) or by taking a new male-like estrogen called tibolone, which can be prescribed for women who cannot take estrogen and it won't cause breakthrough bleeding (13).
1) JAMA article and editorial, January 26, 2000.
2) A Brzezinski, H Adlercreutz, R Shaoul, A Rosler, A Shmueli, V Tanos, JG Schenker. Short-term effects of phytoestrogen-rich diet on postmenopausal women. Menopause - the Journal of the North American. Menopause Society 4: 2 (SUM 1997):89-94. Address: A Brzezinski, Hebrew Univ Jerusalem, Hadassah Med Sch, Hadassah Med Ctr, Dept Obstet & Gynecol, IL-91120 Jerusalem, Israel.
3) S Barnes. The chemopreventive properties of soy isoflavonoids in animal models of breast cancer. Breast Cancer Research and treatment 46: 2-3(NOV-DEC 1997):169-179.
4) G Maskarinec, S Singh, LX Meng, AA Franke. Dietary soy intake and urinary isoflavone excretion among women from a multiethnic population. Cancer Epidemiology Biomarkers & Prevention 7: 7(JUL 1998):613-619.
5) PL Crowell. Monoterpenes in breast cancer chemoprevention. Breast Cancer Research and Treatment 46: 2-3(NOV-DEC 1997):191-197.
6) A Brzezinski, H Adlercreutz, R Shaoul, A Rosler, A Shmueli, V Tanos, JG Schenker. Short-term effects of phytoestrogen-rich diet on postmenopausal women. Menopause - the Journal of the North American. Menopause Society 4: 2 (SUM 1997):89-94.
7) P Albertazzi, F Pansini, G Bonaccorsi, L Zanotti, E Forini, D Dealoysio. The effect of dietary soy supplementation on hot flushes. Obstetrics and Gynecology 91: 1 (JAN 1998):6-11.
8) C Nagata, M Kabuto, Y Kurisu, H Shimizu. Decreased serum estradiol concentration associated with high dietary intake of soy products in premenopausal Japanese women. Nutrition and Cancer - an International Journal 29: 3(1997):228-233.
9) M Hammar, S Christau, J Nathorstboos, T Rud, K Garre. A double-blind, randomised trial comparing the effects of tibolone and continuous combined hormone replacement therapy in postmenopausal women with menopausal symptoms. British Journal of Obstetrics and Gynaecology 105: 8(AUG 1998):904-911. Address M Hammar, Linkoping Univ Hosp, Fac Hlth Sci, Dept Obstet & Gynaecol, S-58185 Linkoping, Sweden.
10) P Albertazzi, F Pansini, G Bonaccorsi, L Zanotti, E Forini, December Dealoysio. The effect of dietary soy supplementation on hot flushes. Obstetrics and Gynecology 91: 1 (JAN 1998):6-11. 60 g of isolated soy protein daily. By the end of the 12th week, patients taking soy had a 45% reduction in their daily hot flushes versus a 30% reduction obtained with placebo (P < .01). 11) P Albertazzi, F Pansini, G Bonaccorsi, L Zanotti, E Forini, D Dealoysio. The effect of dietary soy supplementation on hot flushes. Obstetrics and Gynecology 91: 1 (JAN 1998):6-11. 12) JD Hirata, LM Swiersz, B Zell, R Small, B Ettinger. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertility and Sterility 68: 6 (DEC 1997):981-986. Address B Ettinger, Kaiser Permanente Med Care Program, Div Res, 3505 Broadway, Oakland, CA 94611 USA. 13) Obstetrics and Gynecology Clinics of North America. 1994(June);21(2):381-390. Reported 2/16/02
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