Here’s a bit more info.
As I mentioned, some people questioned the WHI data because of the age of the study participants. This abstract sums up some of the frustration. WHI risks: Any relevance to menopause management?
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.
But, the data is being re-analyzed. Recent Info About Heart Disease and Stroke:
The research just reported in April is trying to unravel some of the data and here’s the recent take on the risk of heart disease that includes a comment on the risk of stroke. Early Estrogen Therapy May Reduce Cardiovascular Risks
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.Recent Info on Blood Clots:
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,"
New research on “blood clots” suggests it may be the route of estrogen administration that influences the risk. This research found hormone patches were far less likely to cause blood clots than pills and that micronized progesterone (bioidentical) did not increase the risk of blood clots.Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study.
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. Recent Info on Cognitive Functioning:
The impact of estrogen on cognitive functioning also suggests that early initiation of therapy might be important.Estrogen, cognition and female ageing
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.
So, in summary, the most recent research (synthetic hormones primarily)seems to suggest that initiating hormone therapy early may reduce the risk of heart disease in younger women, there is a “slight” increased risk of stroke, taking estrogen “transdermally” and micronized progesterone do not increase the risk of blood clots, and early estrogen therapy might have a positive impact on cognitive functioning.
Connie, I totally agree with you that it’s really frustrating trying to figure it all out. I do want to say though that because the scope and duration of the research on so called natural or “bio-identical” hormones doesn’t match that of the “synthetics”, I don’t think anyone really knows if natural hormones are “safer” than synthetics, even if there is some initial research suggesting that might be the case.
Last, I’ll try to give you my perspective on steroids in another post. Suffice it to say that I basically think estrogen (and other hormones) may offer people with MS neuroprotection and steroids (synthetic “cortisol” if you will) may contribute to neurodegeneration in people with MS.
Another long post, sorry about that.