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Hormone Replacement - Bad or Good?
An_248316 posted:
I just read an article saying that taking estrogen and progestin for more than a few years can be harmful or even contribute to a risk of breast cancer. There seemed to be some disagreement on the results of the study. still. Holy cow! Do these studies account for the women who have been taking birth control since the age of 16? I started taking birth control when I was 17. For me, it provided not only contraception, but better skin, a minimal period, almost no PMS and a much better emotional state than without. I stopped only to get pregnant when I was 31 and again for another child at 34. After my second child my period was very erratic. My doctor told me to go back on the pill and "see if my period comes back." It did, and it continued to mask my peri-menopausal symptoms until I was 39. When I say, mask, it reduced the symptoms enough that I didn't worry about it. Still had night sweats and panic disorders. At 39, I missed a few doses and decided to skip a month. After 3 months I realized my period was never coming back. A blood test confirmed that my FSH levels were over 100. My doctor strongly suggested I go back on the pill to prevent bone loss. She said that typical HRT levels are too low for someone under 40. I also asked my doctor if there was any concern with being on the pill since the age of 17. She said no. I am now 41 and I've been on the pill (with a few years off) for 24 yrs. Should I be concerned?
Anon_6061 responded:
I'm glad you posted this. I've always wondered the same thing. I hope Dr. Minkin responds. So many women take BCP's for many years (even decades) and doctors don't seem one bit concerned about that but when talking HRT, it's oftentimes another story.
Mary Jane Minkin, MD replied to Anon_6061's response:
Dear Anon_6061 and 248316,
Very good and complex questions. Indeed birth control pill use, even for many years, doesn't seem to increase the risk of breast cancer; the feeling of many experts is that young women have high hormone levels anyway, so the pill isn't that much of an addition of hormones. The question is for women after menopause, when hormone levels go down significantly, what is the effect of giving back hormones? Birth control pills do have much more hormones than regular hormonal "replacement" therapy. However, the magnitude of the increased risk with "hormone replacement therapy" is not huge, but is statistically significant.
An_248316, if you were to feel fine on HRT, then it's fine. For a young woman like you, you don't need a large amount of estrogen to protect the bones and the heart; a small amount will usually suffice. However, your doctor is right that many young women need more of a hormonal dose; they don't feel well on a very small amount. So I think it's fine for you to see how you feel. Most menopause experts recommend that women who go through very early menopause stay on hormone therapy of some sort until the typical age of menopause, in the early 50 range.
Good luck,
Mary Jane

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