Study Suggests Elevated Risks After Stopping Hormone Therapy

 

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Study Points to Increased Risks After Stopping Hormone Therapy A new study shows an increased risk of death from heart attack and stroke in the first year after stopping hormone therapy for women under age 60. New Study Points to Increased Risks after Stopping Hormone Therapy Once again the yin/yang of hormone therapy (HT) is in the crosshairs. On the one hand, estrogen is the only truly effective treatment for vasomotor symptoms (hot flashes) during menopause. Estrogen also helps ease vaginal dryness, night sweats, and. Isaac Schiff, MD, goes over the pros and cons of quitting of hormone therapy with his patients every year.

He says he puts the cons, like breast cancer risk, in perspective. Stopping hormone therapy risks. NEW YORK (Reuters Health) -Though long-term hormone replacement therapy has serious health risks, going off the medication may lead to a return of menopausal symptoms and increased risk for high blood pressure, according to a new study. Taking estrogen or estrogen and progesterone hormones.

The researchers found that combined hormone replacement therapy (HRT) with estrogen and progestin increases the risk of breast cancer, with effects that last for years after women discontinue. When a woman comes off of hormone therapy, any potential increase in her risk of breast cancer quickly goes back to her baseline norm. This is why hormone therapy can be a safe option when women in their 50s (who are generally at lower risk for breast cancer compared to older women).

NEW YORK (Reuters Health) -Though long-term hormone replacement therapy has serious health risks, going off the medication may lead to a return of menopausal symptoms and increased risk for high. But if hormone therapy is started before the age of 60 or within 10 years of menopause, the benefits appear to outweigh the risks. Type of hormone therapy.

The risks of hormone therapy vary depending on whether estrogen is given alone or with progestin, and on the dose and type of estrogen. Health history. Because of the link between using hormone replacement therapy (HRT) and increased breast cancer risk, HRT should be used at the lowest possible dose and for the shortest period of time possible to help manage menopausal symptoms.

When a woman stops taking HRT, menopausal symptoms may come back. Stopping HRT. The WHI demonstrated that the use of estrogen plus progestin hormone therapy after menopause increased the risk for heart disease, stroke, blood clots, breast cancer, and dementia.

Although hormone therapy with estrogen alone had some benefits for younger women who had a prior hysterectomy, estrogen increased.

List of related literature:

This finding, in combination with observational studies suggesting improved cardiovascular risk with estrogen therapy in menopause, resulted in the conclusion that postmenopausal use of estrogen protected against cardiovascular disease.

“Medical Phisiology: Principles for Clinical Medicine” by Rodney A. Rhoades, David R. Bell
from Medical Phisiology: Principles for Clinical Medicine
by Rodney A. Rhoades, David R. Bell
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012

In addition, findings reported from observational epidemiologic studies suggested that use of estrogen or combined hormone (estrogen plus progestin) therapy reduced risk of coronary heart disease (CHD) events.

“Osteoporosis” by Robert Marcus, David W. Dempster, Jane A. Cauley, David Feldman
from Osteoporosis
by Robert Marcus, David W. Dempster, et. al.
Elsevier Science, 2013

Certain of these risk factors indicate that an altered endocrine state with increased estrogen stimulation is a predisposing cause, and one might thus in theory expect estrogen treatment (and notably hormonal replacement therapy) to increase the risk (SEDA-22, 466).

“Meyler's Side Effects of Endocrine and Metabolic Drugs” by Jeffrey K. Aronson
from Meyler’s Side Effects of Endocrine and Metabolic Drugs
by Jeffrey K. Aronson
Elsevier Science, 2009

When preliminary findings of the study indicated that long-term use of hormone replacement therapy (HRT) was associated with increased health risks among the participants, the HRT arm of the WHI study was discontinued.

“Ethics & Issues In Contemporary Nursing E-Book” by Margaret A Burkhardt, Alvita K Nathaniel
from Ethics & Issues In Contemporary Nursing E-Book
by Margaret A Burkhardt, Alvita K Nathaniel
Elsevier Health Sciences, 2019

The second example involves a series of observational studies reported in Pettiti (1998) which find evidence of beneficial effects of hormone replacement therapy (HRT) and estrogen replacement therapy (ERT) on coronary heart disease (CHD).

“A Modern Approach to Regression with R” by Simon Sheather
from A Modern Approach to Regression with R
by Simon Sheather
Springer New York, 2009

Research contributing to evidence-based practice indicates that hormone replacement with estrogen and progesterone increases the risk for cardiovascular disease.

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from Study Guide for Medical-Surgical Nursing E-Book: Assessment and Management of Clinical Problems
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Elsevier Health Sciences, 2015

Additionally, women enrolled in the hormone therapy arm had increased risk for cognitive dysfunction, decreased bone disease, and gastroenterological cancer.

“Goldman-Cecil Medicine E-Book” by Lee Goldman, Andrew I. Schafer
from Goldman-Cecil Medicine E-Book
by Lee Goldman, Andrew I. Schafer
Elsevier Health Sciences, 2019

Studies have also demonstrated higher risks when hormone therapy is begun before or soon after menopause than after a longer gap (Beral et al., 2011).

“Cancer Epidemiology and Prevention” by Michael Thun, Martha S. Linet, James R. Cerhan, Christopher A. Haiman, David Schottenfeld
from Cancer Epidemiology and Prevention
by Michael Thun, Martha S. Linet, et. al.
Oxford University Press, 2017

Postmenopausal women also lose the beneficial effects of estrogen on lipoprotein profile (i.e., high HDL, low LDL) and are at greater risk for cardiovascular disease.

“Endocrine and Reproductive Physiology E-Book” by Bruce White, John R Harrison, Lisa Mehlmann
from Endocrine and Reproductive Physiology E-Book
by Bruce White, John R Harrison, Lisa Mehlmann
Elsevier Health Sciences, 2018

These observations, bolstered by considerable basic biology supporting the idea of the beneficial effects of estrogens on the cardiovascular system, led to the widespread belief in the 1990s that postmenopausal hormone therapy (HT) would reduce the risk of CVD.

“Women and Health” by Marlene B. Goldman, Rebecca Troisi, Kathryn M. Rexrode
from Women and Health
by Marlene B. Goldman, Rebecca Troisi, Kathryn M. Rexrode
Elsevier Science, 2012

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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23 comments

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  • Dear Barbara, wishing you a happy healthy new decade

    THANK YOU so very much for the amazing free information you have given us over the years. Your knowledge and experience is priceless. For those of us who are lucky enough to be following your channel you have given us so much fantastic opportunities to take our health into our own hands by being educated. Im looking forward to learning more over the coming years xx

  • Merry Holiday! WooHoo, up 10k subscribers since I started keeping track a few months ago. Have a great day Dr. Barbie. You are our “gift that keeps on giving” every week.

  • Dear Dr Taylor, whilst you are doing amazing job educating women, you are misleading your audience on the role of progesterone, as your knowledge seems to be based on the 80s research (as is your approach to nutrition). Perhaps a few words on the density of progesterone receptors in the brain, impact on libido, cell differentiation and bone growth would be valuable to your readers. Pubmed is free. Sorry but I had to send your book back, it is so outdated.

  • So what IS the right dose of estrogen when taking hrt to prevent heart attack? How do you know if you are taking enough? Blood test results? How many milligrams etc? Thanks! Wonderful video as always!!!

  • I am 46 and I’m taking 2 pumps of estrogel as I’m going thru surgical menopause..My doctor wants me to gradually decrease hrt doses (estrogel)…I don’t want to..not sure what to do..heart problems are in family…wondering if you can prescribe and how your prescriptions would work across the border in Canada..Mery Christmas, and wishing you a very very happy new year! You were the best thing I found in 2019. Lots of love and hugs! God bless you

  • Can anyone explain who in the He*# came up with the term “Menopause?”
    I mean there is no “pause!” That’s it Finito goodbye to periods, Estrogen!!!
    Someone needs to come up with a better definition because Menarch ENDS! ESTROGEN ENDS, Heck sometimes it feels like the wonder of the idea of a carefree “I can’t fall pregnant ever again!” Has so many painful distressing side effects. Dryness, fatigue…
    I mean if you have the money for all the supplements, HRT & consultations to a caring Gynae well all power to you!
    But for those of us who are shrivelling up in one way or another its F-ing Hell ������

  • I take Progesterone because I have Sleep Apnea, as well as Perimenopause. When women lose their Progesterone in Perimenopause, I understand that their Sleep Apnea risk goes up 4x. It is an airway muscle stimulant. Dr. Steven Park, an ENT and sleep specialist sin NYC has information regarding this on his clinical website. My Dentist also said to get on Progestogen to keep my bones strong. He said it helps women keep their teeth and jaw bone thickness longer, as it preserves jawbone and tooth roots. It also slows facial bone loss and aging. There is an interesting Old Wives saying about losing ‘a tooth for every baby’. (The up and down of the hormones.)

  • I think most people in this comment section don’t actually realise that Jay wasn’t detransitioning, or stopping HRT because they weren’t trans, it was because they realised that their gender identity was not male and therefore did not want to change their body further to present more masculine. They took the right decision for themselves.

  • Merry Christmas Dr. Taylor! I had my consultation with you a little over a year ago. I saw a wonderful physician who put me on the Combi patch and it was working wonderful until I started to get a reaction to the patch, redness, burning, itching. It was pretty bad. Than I started getting severe migraines, I ended up in the ER with the worst one I have had. At the year mark of being on the patch I had a follow up appointment with my doctor and because of the symptoms of migraine and reaction to the patch she took me off of it and referred my to an Integrative Medicine Physician. I will be seeing her soon. I’m hopeful she can help me.

  • Fascinating information. I need to watch 85 and 177. My obgyn originally said lowest dosage, shortest amount of time due to the risk of developing blood clots. No history in my family, but I am over weight. A few years later, because I am on a lower than prescribed dosage, she said I could stay on it for life. Now I wonder if the risk of heart attack outweighs the risk of blood clots. Must do more research…

  • What happens if your practitioner has lowered your dose and now your estrogen is much lower, is it like starting all over when you increase your dose.? Mind you I’ve never stopped taking the estrogen.

  • I pray for my transgender family member every day that he will transition back to who he was born as. I do not think taking hormones are safe or healthy, our bodies were not designed to take them. And although I respect his wishes and will love him no matter what, I do believe he is being deceived. Transgender decisions are often done too young. I think a person considering transgendering should have extensive therapy before going through invasive surgeries and taking hormones. Some transgenders have said exactly this, “that they wished the Dr they were seeing didn’t ok them for treatment & surgery so fast”.

  • The doctor seemed a bit disappointed that she didn’t want to continue to go through with it. Good for her, she took control of her own body back. <3

  • My gynecologist told me that once women are age 65 and on Medicare, insurance will no longer cover HRT. Dr. Taylor, what should we do to petition for a change in that policy? HRT protects or reduces the likelihood women will develop dementia, osteoporosis, or have a heart attack.

  • The Dr I go to had a patient that had breast cancer (it was being treated) and she said there was no way she was going to give up her HRT during this time. From what I have learned about HRT and the good things it does for your body I plan on using it forever! I hope I won’t have to find a new Dr because mine would retire but I am in for that fight if it should happen. Thanks for all the great information you share as it just re in forces wha I have learned. Thanks ��

  • Hope there will eventually be research to help women who missed the boat on HRT and are now in 70s. Most of our mothers were not advised to take it in previous years and I guess it’s not currently recommended for them to start HRT at later ages. A huge number of women left out.

  • Great info, I had hysterectomy a year ago but I do have my ovaries, my body haven’t been the same since, if I start estrogen therapy due to the fact that I do have my ovaries do I need to take Progesterone as well?

  • Dr Taylor, u said risk increases 2 -3 times in the very first year the hrt is stopped. Is this risk same or comparable to the women who have never had hrt. I don’t know whether I ve framed my question properly.

  • I hope there is some way for you to get this message out to doctors. They are the ones we go to to get treatment. I have not encountered one that had any idea that estrogen was necessary for more than a few years, or that we should take it for things like our hearts or bones, for prevention. They only care about hot flashes. That was all the way up to a menopause specialist. Its not us women that have these false ideas, its the doctors we go to for help.

  • My doctor said theres no protection against heart attack with HRT.
    Any type of HRT affects my eyesight. My right eye gets fuzzy, much worse in the morning. Id perfect eyesight before i started hrt. Ive tried loads of different types, patches, pills, everything. I couldn’t take pill/minipill without migraine and aura in that same eye. Any help for me?

  • I thought it was very interesting that the family referred to their child as the opposing gender to that which they bore. “He, Him’ all the while this person admits to not ever even thinking in definite terms like that, not even once apparently, but rather was approaching the process with not only optimism but a healthy and appropriate degree of skepticism as well. I believe the family being so supportive gave this person the most healthy environment to exercise a full level of good judgment by evaluating their own selves properly and making a firm commitment at the end of the day. It must be devastating for people who rush in and opt for surgeries and face regret of never having the opportunity to bare a gorgeous child after the damage has been irreversibly done. The whole concept of gender identification and neutrality is based upon the cornerstone of achieving peace with yourself. I believe few things will endure the highest levels of controversy and criticism as gender transitioning in this world, ever. And rightly so, it is extremely obscure and radical once you enter into the surgical side of this world as it is still a relatively newly ventured biome and with that comes a multitude of complications as well as horror stories. This persons world is extraordinary and they look to be re imagining their dreams which is always a beautiful and frightening experience.

  • Merry Christmas lovely Barbie!!!! We actually had a storm here in Brisbane today and had much needed rain…. the best Chrissy present ever!!!!! Hope Santa found you!!!:) xx

  • Exactly! It is like when you purchase something with a Lifetime Guarantee…whose lifetime?..mine or it?
    Great tutorial with much passion!