lyndacarol wrote:By the way, researchers in Scotland (Behan and Chaudhuri) stated in a paper (posted by finn under General Discussion) that pregnancy was more effective than the interferons.
my wife is under 30, so concerned about using a hormone replacement drug at a young age.
Why was the estrogen-alone study stopped?
In March 2004 the estrogen-alone study was stopped after an average of 7.1 years of follow-up because of evidence of an increased risk of stroke (44 women taking estrogen had strokes versus 32 women taking placebo), with no benefit for coronary heart disease. The increased risk of stroke was similar to what was found in the estrogen-plus-progestin study when that trial was stopped in 2002. Surprisingly, there was no increase in risk of breast cancer in women receiving estrogen alone and the trend suggested a 27% reduction. At the time the study was discontinued, enough data had been obtained to assess the overall risks and benefits of the use of estrogen in this trial.
My wife has RRMS cannot take interferons (persistent elevated liver enzymes) or Copaxone (allergic reaction after 2 months) anymore. Her neurologist, who is great, is recommending pulse steroids every 3 months.
Are you on estriol - has it helped you?
RESULTS: Patients with high estradiol and low progesterone levels had a significantly greater number of Gd enhancing lesions than those with low levels of both these hormones. Patients with a high estrogen to progesterone ratio had a significantly greater number of active MRI lesions than those with a low ratio. CONCLUSION: Estradiol and progesterone may influence disease activity in MS. If further studies confirm these results, it may be possible to develop therapy by altering levels of these hormones.
The ratio of progesterone/17-beta-estradiol during the luteal phase was significantly associated with both number (r = 0.6, p = 0.03) and volume (r = 0.7, p = 0.009) of enhancing lesions, providing support for a role of these hormones as immunomodulatory factors in MS.
The aim of this study was to assess whether an association exists between the premenstrual period and exacerbations of multiple sclerosis (MS)…..in 45% all exacerbations had started during the premenstrual phase
Therefore the reported overall cardiovascular risks in WHI, in both treatment arms, should be regarded as irrelevant to menopause management. In contrast, breast cancer risk is relevant, providing that proper note is taken of the fact that there was no increased risk after five years of combined hormone therapy in non-prior HT users and there was a tendency to a decreased risk in oestrogen only treated individuals.
A new analysis of both estrogen and estrogen plus progestin data from the Women's Health Initiative (WHI) hormone trials in the Journal of the American Medical Association shows a 24 percent reduction in risk for coronary heart disease events in women starting hormone therapy less than 10 years after menopause.
The analysis, by researchers at Yale and eight other study centers participating in the Kronos Early Estrogen Prevention Study (KEEPS), also showed a 30 percent reduction in overall deaths among women aged 50 to 59 using hormone therapy.
However, the new study, "Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause," also found that hormone therapy increased coronary heart disease events by 28 percent in older women, and that deaths increased by 14 percent in women aged 70 to 79. There was a slightly elevated risk of stroke at all ages studied.
"This new analysis of WHI data seems to confirm earlier findings that estrogen may be good early, but bad late,"
CONCLUSIONS: Oral but not transdermal estrogen is associated with an increased VTE risk. In addition, our data suggest that norpregnane derivatives may be thrombogenic, whereas micronized progesterone and pregnane derivatives appear safe with respect to thrombotic risk. If confirmed, these findings could benefit women in the management of their menopausal symptoms with respect to the VTE risk associated with oral estrogen and use of progestogens.
These findings suggest the presence of a critical period for HRT-related neuroprotection and underlie the potential importance of early initiation of therapy for cognitive benefit.
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