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Fact or fiction? Estrogen therapy is an option for all menopausal women
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THE NORTH AMERICAN MENOPAUSE SOCIETY
Cynthia A Stuenkel, MD, NCMP posted:
Fiction: Only women who no longer have a uterus should consider using esdtrogen-alone therapy (ET). For women with a uterus, the option they might consider is estrogen plus progestogen therapy (EPT). Progestogen is needed to protect the uterus and balance the effects of estrogen. Using ET alone for 5 or more years can more than triple the risk of developing cancer of the uterus, but adding progestogen prevents the uterine lining (endometrium) from thickening and greatly reduces the cancer risk. Then, of course, each woman must determine (with her healthcare provider) if EPT is right for her. See the NAMS Web site for more information.
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wcmom responded:
I am 49 year old woman who was put on Estriol, the estrogen only gel to help battle perimenopausal symptoms and balance out my hypothyroid. The estrogen feels similar to taking a Zanax, I feel less anxious and am sleeping better. The P.A. from my endocrynologist says the opposite, that cancer occur in women who add in progestogen. Is there that much conflicting info out there? I have friend who use a progestogen cream on there arms because they have been told they are estrogen dominate. I feel better taking the estrogen, but am not at the expense of my health.
 
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Mary Jane Minkin, MD replied to wcmom's response:
Dear wcmom,
Estriol is a very mild estrogen; however, I would not recommend that you take estriol. Estriol is not approved by the FDA in this country, and its production is not well regulated. There are bioidentical estrogens available from certified pharmaceutical companies; they are plant derived, and quite well regulated. You can get them in very low doses, too; there are gels and patches, all of which are indeed bioidentical. If you do use estrogen and have a uterus, you do want to take some progesterone periodically. There is indeed a bioidentical pill available, of oral micronized natural progesterone; and there are also vaginal gels available, again with micronized natural progesterone. So you can obtain all of these bioidentical products from regulated sources. The smaller the amount of estrogen that you use, the less progesterone you will need to use.
Most women will do quite well with the estrogen, and I am glad you are feeling better; don't be scared by having to take the progesterone; on a low dose, you won't need to take it very often.
Good luck,
MaryJane


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