Don’t Count On Estrogen To Help The Heart

The estrogen ship has sunk. For years women were urged to take hormones even if they had no menopausal symptoms. The estrogen was believed to protect their bones as well as their hearts.
Women who were nervous about the potential added risk of breast cancer were sometimes told that heart disease was the main killer of women. Occasionally physicians would go so far as to suggest that breast cancer was easy to treat, but heart disease was lethal.
One reader complained about being coerced into taking estrogen: “After my breast cancer operation, the first thing I was told was that I could no longer take estrogen, because my tumor was ‘estrogen-nurtured.’ The surgeon admitted this. My primary physician’s position was–and continues to be-‘The benefits far outweigh the threat of breast cancer, and besides, WE CAN CURE BREAST CANCER.’ That’s what he said!”
The belief that hormones protected women from heart disease was never based on well-conducted scientific studies and has now been undermined by the evidence. The Women’s Health Initiative was designed to evaluate the long-term pros and cons of hormone replacement therapy (HRT). Preliminary results were so alarming that the study was halted prematurely. Women on HRT were more susceptible to heart disease, strokes, blood clots and breast cancer.
The unexpected announcement came on the heels of a report in the Journal of the American Medical Association (July 3, 2002) confirming that women on hormone replacement therapy are just as susceptible to heart attacks as those on placebo, even after seven years of follow-up.
Researchers had originally hoped that over the longer term, the beneficial effects of estrogen on cholesterol would protect the heart. But not only did HRT not lower the rate of heart attack, this well-conducted trial did not find that HRT prevented bone fractures. Women taking hormones did have a higher risk of serious blood clots and gallbladder disease, however.
Despite this bad news, hormone replacement therapy can be valuable for women who are suffering from hot flashes, night sweats, sleeping difficulties and vaginal dryness. Such menopausal symptoms respond beautifully to low doses of estrogen. Exposure for several years does not seem to increase the risk of breast cancer significantly.
But when it comes to heart disease prevention, women should now follow the same advice doctors have been giving men for decades. A diet rich in fruits, vegetables, low-fat dairy products, high-fiber whole grains and olive oil, adequate exercise, cholesterol and blood pressure control as well as aspirin when appropriate are prudent steps to a healthy heart.
For women who would like to know more about their options, especially non-estrogen alternatives, we have prepared Guides to Estrogen, Heart Health and Osteoporosis. Anyone who would like copies, please send $4 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. CWU-852, P. O. Box 52027, Durham, NC 27717-2027.
Women at risk of osteoporosis also have alternatives to estrogen to help keep their bones strong. Medications such as Actonel, Fosamax, Evista or Miacalcin have been shown to improve bone density and reduce the risk of fracture. Regular exercise and adequate calcium and vitamin D are also critical.