LONG-TERM ESTROGEN NOT CAUSE WEIGHT GAIN
Report #6685 1/6/96
The two most-often voiced arguments against taking estrogen after the menopause are that it can cause weight gain and breast cancer. Recent studies show that it may cause neither.
The first report ever to test the effects of long-term estrogen after the menopause on weight gain was published recently in the Journal of the American Medical Association. It shows that more than 15 years of continuous estrogen does not cause weight gain.(1) There is a slight increase in breast cancer (2,3), but that increase does not show up until after 5 years of taking estrogen (4)/ and could be due to the fact that women who take estrogen are more likely to get mammograms (5) which pick up breast cancer before a women would die of something else (6).
The vast majority of gynecologists recommend estrogen for their postmenopausal patients because it prevents loss of height, osteoporosis, heart attacks, strokes, vaginal dryness, loss of teeth, lowered IQ, depression, colon cancer and hot flushes. Estrogen benefits depend on how it is taken. Estrogen helps to prevent heart attacks only when it is taken by pill. (7) It goes from the intestines to the liver where it raises blood levels of the good HDL cholesterol which helps to prevent heart attacks. When it is taken by patch or injection, it does not reach the liver and does not raise blood levels of the good HDL cholesterol. When estrogen is taken by mouth, it causes migraine headaches in susceptible people. When it is taken by skin patch, it usually does not cause migraine headaches.
By Gabe Mirkin, M.D., for CBS Radio News
1) Kritz-Silverstein D, Barrett-Connor E. Long-term postmenopausal hormone use, obesity,
and fat distribution in older women. JAMA 1996(Jan 3);275(1):46-49.
2) FG Nason, Nelson BE: Primary Care for the Mature Woman 1994(June);21(2):245-269.
3) Harlap S. The benefits and risks of hormone replacement therapy. Am J Obstet Gynecol
1992;166:1986.
4) GA Colditz et al. The Use of estrogen and progestins and the risk of breast cancer in
postmenopausal women. NEJM 1995(June 15);332 (24):1589-1593.
5) T Seeley. Do women taking hormone replacement therapy have a higher uptake of
screening mammogram? Maturitas 1994(Aug);19(2):93-96.
6) LM Wun, EJ Feuer, BA Miller. Are increases in mammographic screening still a valid
explanation for trends in breast cancer incidence in the United States? Cancer Causes
& Control 6: 2 (MAR 1995):135-144.
7) R Gass, M Neff. For the prevention of postmenopausal osteoporosis: How beneficial is transdermal hormone replacement therapy? Schweizerische Medizinische Wochenschrift 1995(Aug 26);125:34:1583-1591.