Long-term estrogen effects?

January 29, 2007 11:14 AM

I've been on estrogen therapy for 26 years - anyone else with similar experience?

I had a complete hysterectomy at age 25 and was immediately put on oral estrogen. Several doctors later, and I've been on a bio-identical estrogen patch for the last 6 years (I'm now 51). I have the same OB/GYN as my 72 year old mother, and he took her off estrogen/progesterone just last year. At my last well-woman exam, I asked when I could stop the therapy and he said "not for a long while".

I feel great, all medical tests, mammograms & bone scans have been good. I'm very concerned about the long-term effects of estrogen therapy, but can't find any published research on instances just like mine - no ovaries, estrogen patch, long-term, etc.

I'm at the point that I'm thinking about finding a different OB/GYN, but not sure if I'm worrying about nothing. Your suggestions are very welcomed...

posted by luckyshirl to health & fitness (5 comments total)

If you are using bio-identicals, don't worry. It's only horse-piss estrogens like Premarin that are proven to be bad for you.

I mean really, the same people who tell us that "cows milk is for perfect food for baby cows but breast milk is best for babies" forget that horse estrogen is not the same thing as human estrogen. For more information than you really want, try here but be warned that a lot of people think she is a little radical. However, if you actually read her book, you will find that a third of the damn thing is citations of actual medical studies.
posted by ilsa at 12:59 PM on January 29, 2007

Not identical experience but similar. Obviously, the decisions I've made (in conjunction with discussions with my gyn) are affected by my own circumstances and may not prove to be the same choices anyone else would make.

I've been on Premarin (just premarin), for 15 years (I'm 44 now). After the initial kerfluffle regarding Premarin, I read the reports, did some thinking, and realized that I'd already been on Premarin so long that any damage likely to be done already had been. My pelvic exams, paps, mammograms all come back fine, and so ultimately, given that when off Premarin I am not a nice person to be around, I chose to stay on it. At my last exam, my doctor and I discussed my going off Premarin when I am 50 or so - a time when had I not had a hysterectomy, I would in all likelihood be post menopausal anyway.

You don't say why your gyn thinks you should stay on the HRT so long, or why he kept your mother on it so long - that I do find curious.

As to studies and such, I'm not going to be any help, sorry. Once I made the decision to stay on Premarin, I pretty much quit worrying about it. Absent knowing why your doctor wants you to stay on HRT indefinitely, I'd say if you're concerned about his course of treatment for you, a consult with another gyn isn't amiss.
posted by faineant at 1:31 PM on January 29, 2007

I'm 45 years old and been on HRT for around 16-17 years. I took the "little purple pill" for the first seven or so and then switched on the recommendation of my then doctor to the weekly patch. Personally, I liked the idea of not worrying about meds every day as well as bypassing the potential issues associated with the stress on the liver.

The patch has worked well for me, but my new doctor says that my hormone levels may be a little low and he wants to talk about some alternatives.
posted by michswiss at 1:47 PM on January 29, 2007

Have you thought about looking for studies on long term hormone use in Male to Female transsexuals? Some more links over on wikipedia.

I know a fair bit of research has been done, so at least some of it should be available on the web.
posted by Z303 at 4:19 PM on January 29, 2007

There isn't a lot of information about women in your particular situation. The Women's Health Initiative only looked at naturally menopausal women, not surgically menopausal women. It is not believed that ERT raises the risk of breast cancer for those of us who have experienced surgical menopause.

Your doctor is likely unwilling to stop ERT for quite some time because the benefits - especially reduced risk of heart disease and osteoporosis - outweigh the risks. Your quality of life and health will likely be better by remaining on ERT in his opinion.

The amount of estrogen in your ERT is far lower than what would be produced by functioning ovaries if you had them. It is also believed that women who have had bilateral salpingo-oopherectomies (even those taking ERT) are at reduced risk of developing breast cancer.

Anyway, I'd suggest talking to your doctor about why he feels you should continue the estrogen replacement, and what the exact risks and benefits of ERT are in your situation. And if you find any specific studies on long-term use of ERT, please let me know. I'll send you anything I find myself.
posted by Felicity Rilke at 6:56 PM on January 29, 2007 [1 favorite]