To Take or Not to take Estrogen – That is the question

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In 1991 the Women’s Health Initiative was begun to see if post menopausal women were befitting from taking estrogen. This was a $725 million dollar project involving 27,000 women. Abruptly in 2002 the NIH (National Institutes of Health) stopped the study and announced that estrogen hormones were increasing the rates of heart attacks.  Millions of women abruptly stopped their estrogen therapy and looked for another means to control their symptoms. Now in a major flip flop new analysis has emerged showing that estrogen may be beneficial for people early in menopause, that is the first ten years of menopause. The new data shows that women aged 50-59 who took estrogen had a 30% lower risk of dying, 10-19 years into menopause had a 22% increased risk,  but if you were over  20 years into menopause and continued to take estrogen you had a 71% increased risk of death .

The problem with this entire study appears to be that the average age was 63 and only about 10% of the women were in their first ten years of menopause. Before this data can be widely disseminated it has to get the approval of the AMA and its publication JAMA (Journal of the American Medical Association). And herein lies the problem. Apparently JAMA has tightened up the statistical requirements for the data to be “statistically significant”.  In technical jargon they are now requiring a P value of .01 not the usual .05. And to put that in layman’s terms for every 10,000 women aged 50-59 who use hormones there would be 10 fewer deaths and in women aged 70-79 there would be 16 additional deaths. Now you don’t have to be a statistician to realize that someone here has a vested interest to get this published and therefore into mainstream medicine as “evidence based medicine”, the new jargon to justify prescription filling. My personal take is if you have to take hormones make sure they are human bio-identical and be judicious – you should not substitute a pill for proper diet and life style.