In sorting out the problem about what to do with estrogen replacement, consider two types of women:

1. takes estrogen to treat symptoms
2. takes estrogen to prevent disease

For the women taking estrogen to prevent symptoms, the PremPro study is very disturbing because the side effects of not having estrogen can be so troublesome as to make life literally painful emotionally and physically.

For the woman who takes estrogen to prevent disease: 

• Estradiol levels over 40 help prevent dementia (but a level of 40 is much lower than what most women achieve when they take Premarin).
• Testosterone replacement helps prevent bone loss better than estrogen
• Estrogen should not be taken to prevent heart disease
• Testosterone (not Estrogen) supports a good sex drive
• Testosterone (not Estrogen) helps more with depression and anxiety
• Estrogen does help prevent vaginal dryness and dysparunia (painful sex) and helps prevent urinary incontinence.  But these effects can be achieved with a vaginal cream without requiring high blood levels.
• Estrogen does help keep skin looking young but again this can be done with a cream that does not raise blood levels significantly.

So, most of the health effects of Estrogen can be achieved with a carefully tailored estrogen cream and a lower estrogen level than what most women have when they take Premarin.

Effects of menopause (like depression, anxiety, and weight gain) that some associate with lower estrogen levels can be better treated with other hormones like testosterone and DHEA.

Also, consider a third type woman:  she feels miserable without estrogen (since menopause) but also feels miserable while on estrogen (remember 40% of the women on the PremPro study dropped out!)

In solving the dilemma consider three things:

1. The study's problems (how it could lead you to the wrong conclusions).
2. The good news about estrogen replacement that you may not know.
3. Some tips on safely replacing estrogen that may shock you.

If you wish me to help you with your hormone replacement, let me know.  I can and do work with many OB/GYN physicians and primary care physicians (you don't have to give up you GYN if you don't want to).

DrRunels@runels.com

http://templerepair.com