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HRT May Improve Indications Of Cardiovascular Disease In Women In Early Menopause, Study Indicates.

April 4, 2016

HRT May Improve Indications Of Cardiovascular Disease In Women In Early Menopause, Study Indicates.

Yet another study pointing indirectly at the benefit of HRT (estrogen or estrogen/progesterone replacement therapy) in the prevention of heart disease.  This study was less dramatic because the interval between menopause and hormone start was expanded to 6 years or less.  Other studies have shown that a large majority of the negative changes due to estrogen deprivation occur in the first 2 years after menopause.  So if we are looking at someone 4-6 years out the benefits seen would be expected to be less.  This finding was shown be very elegant studies by Clarkson, et al, years ago in a very clean primate model.  His results showed dramatic differences in plaque formation but the estrogen was started immediately after the loss of hormones.  Also remember, many patients on hormone replacement are not getting adequate levels.  Most physicians don’t check levels at all.  When epidemiological studies are performed, this variable can not be controlled for and any benefit is significantly diluted out.
As this summary points out, despite longstanding, and growing evidence that HRT is protective of cardiovascular disease, the ACOG stance continues to be use lowest dose for shortest period to control symptoms (hot flashed and night sweats).  Sadly, these represent the least medically concerning symptoms of estrogen deprivation.
 http://www.wsj.com/articles/using-hormone-therapy-early-may-prevent-heart-disease-study-finds-1459371601
Michael D. Fox, MD
Jacksonville Center
Reproductive Medicine
jcrm.org 

   
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