A few things to note about the study are:
- 40% of the women stopped the
drug before the study was over. In some studies up to 50% drop their
hormone replacement therapy (hrt) within the first year. Clearly,
there is something to be learned about how to make hrt more tolerable.
- All of the women took the same
dosage. I don't know another medication with the potential dangers of
estrogen where blood levels are not followed (when available). With
thyroid medication, we do not give everyone the same dosage. Even with
several different dosage forms of thyroid, even more elaborate dosing
patterns are frequently used to obtain a blood level that is high enough to
do the job and not so high to cause danger (therapeutic range). I
contacted the researchers and no estrogen levels are being reported yet.
Blood levels will be measured but the data is not available yet.
- The increased incidence of
heart disease, stroke, and pulmonary embolus was not correlated to weight.
I don't think you would see this increased risk in these three events if the
estrogen/progesterone combination was not given to the very obese.
Again, this data is not available yet but it could be that you do not see
this increase in these diseases in those who practice a healthy lifestyle.
- This study used estrogen that
is taken from a mare's urine (Premarin) and synthetic progesterone (Provera).
We have good evidence that estrogen and
progesterone natural to a woman's body (available from compounding
pharmacies) might not be as dangerous. Some studies of estriol
(another form of estrogen--Premarin is mostly estradiol) even seemed
to show that the hormone protects a woman from breast cancer.
- If you want to read
some of the study results for yourself and the opinion of the
researchers you can go to the following sites:
- The actual JAMA
article
- Findings
and implications according to the researchers who did the study.
When you've looked at things to be convinced that this study had it's
problems (conclusions to be made still fuzzy), then go back to core article and
read some good news about estrogen.