I’m asked quite often for suggestions and opinions on hormone therapy. A topic which, if you’ve done much reading, has gone through many evolutions and machinations for close to 100 years now. As with most things pertaining to our health (think coffee) we love it, we hate it, we love it, we hate it, it’s good for you, it’s bad for you, it’s good for you, it’s bad for you. And estrogen is no different.
We’ve Circled Back Again
When I started going through perimenopause in the late 1990s and early 2000s, the Women’s Health Initiative study had just been released and the whole damn medical community had gone bat shit crazy. NOBODY wanted to prescribe women hormone therapy for perimenopause symptoms ,for fear they were writing your prescription for certain death from stroke, blood clots, heart attacks, or an increased risk of breast cancer.
Never mind that they had zero problem writing prescriptions for birth control pills or antidepressants. But, if you wanted hormone therapy or anything that resembled it, you had to work really hard to find someone willing to help you. Thankfully, a lot of the fervor and high anxiety surrounding the use of estrogen during perimenopause and menopause has died down considerably, and the medical community seems to be rallying around the use of estrogen once again.
Part of the Problem is Medical Research is Never Conclusive
One of the things that has made this subject so difficult for me personally and as a blogger (and I’m sure for you, the reader as well), is that the more research I’ve read, and the more experts I’ve listened to, the more contradictions and differing opinions I came across. It can be exasperating. Who the heck do you believe when you have equally credible, sincere, and passionate experts disagreeing on the best treatment for something like perimenopause and menopause?
Incidentally, I’ve also had the pleasure (I think?) of being told point blank by a nationally well known physician that there is “no such thing as bioidentical hormones – period.” I mean, never mind that the FDA has issued its own list of bioidentical hormones. But, okay.
So what do you do? Who do you believe? What is right? Estrogen yes? Estrogen no?
Get in the Middle and Stay There
I posed this question to a local physician a number of years ago, and her answer was probably one of the best pieces of medical advice I’ve ever received. “Get in the middle,” she said, “and stay there.”
I loved this answer for a number of reasons. Primarily because when you’re standing in the middle, you really have the best vantage point, don’t you? I mean, you can see “both” sides as it were, and if you’re not necessarily wedded to one view or another, it’s easy to reason your way through the information to arrive at a comfortable opinion of your own. Which is exactly what I’ve done.
I decided a number of years ago that estrogen has its benefits. I also decided, (contrary to said nationally well known physician referenced above) that there are a such thing as bioidentical hormones, and they are in fact, better, MUCH better than their synthetic cousins.
But I don’t think that everybody should use estrogen. What I think is that you should do exactly what I did: educate yourself with as much information as possible from reasonable, rational, credible sources, and then decide what you think is the best treatment option for you.
I’m someone who came late to hormone therapy, in that I didn’t begin estrogen therapy until I was actually post-menopausal. And I didn’t begin using progesterone until I was almost menopausal.
Which is really more of a reflection of my confusion for years about what was right and what was wrong more than anything else.
The Estrogen Window
If you are considering the use of estrogen therapy during perimenopause or perhaps even into menopause as I’ve done, you might find this book interesting and of some use on your own quest to find what is best for you.
The Estrogen Window: the breakthrough guide to being healthy, energized, and hormonally balanced – through perimenopause, menopause and beyond, by Dr. Mache Seibel, MD is an excellent starting point.
But, if you’re looking for quick and dirty answers, this might not be the book for you. It’s detailed, but in my opinion, not so much like a medical journal or textbook that you, the layperson, can’t figure it out and make sense out of it.
I recommend the book for a few reasons, but primarily because I think it’s important to get a balanced view of estrogen. There are so many schools of thought out there about whether women should or shouldn’t use estrogen.
But the one which bugs me the most is that “it’s natural” and so we shouldn’t interfere with what is “natural” and just let nature take its course. Which sounds good and everything, but…..vaginal dryness anyone? Vaginal atrophy? Insomnia? Dry, crepey, aging skin? Loss of tone in vaginal walls? Loss of libido? Depression?
All of these issues are associated with low estrogen. And yes, I realize that we’re all going to get old no matter what we do, but seriously? Why would I just stand idly by and let these things happen to my body when I don’t have to? Yes, I understand there is a risk associated with estrogen therapy. But, there’s a risk associated with Tylenol, Motrin, and Aleve. The question to me is, how do you balance and mitigate that risk?
Which means do your research.
Dr. Mache talks about the estrogen window in this book ,hence the title. Meaning that there is an optimum time for you to use estrogen for maximum benefit. But for me, the jury is still out on that one. I’m an advocate of how you feel to determine if something is working for you, regardless of your age and when you begin using estrogen.
Because, frankly, as a 60-something year old woman, who is post-menopausal, there are some medical experts who would say I don’t need to use estrogen, and that the longer I use it, the more I increase my risk for breast cancer, stroke, and other health issues.
I don’t know if I agree with that or not. And I certainly would not encourage any of you to follow my example. I’m just going to share my personal experience with you, present the information to you, and provide as much support as I possibly can. But, you and only you can determine if estrogen therapy is right or wrong for you.
But, I will strongly suggest that you consider reading the book and having it in your library. It’s an excellent resource and could be just what you need to help you make the decision for your own hormonal health.