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Sex Files: O God! Sex Files: Just push “Play” Sex Files: It’s how you play the game Sex Files: The hard truth Sex Files: Know your anatomy |
Hormones get the rap for a lot of things. Plenty of questions surround them, too. Is it true that your sexual desire is closely linked to testosterone levels in your blood? Does the Pill affect your libido? Are bioidentical hormones safer than others? Should women even be taking hormones in the first place?
In this column, we’ll focus on whether it is safe for women to take hormones—a question that has been on women’s minds for the past five years. In early 2002 the Women’s Health Initiative (WHI) study on combined estrogen and progestin treatment in postmenopausal women was stopped prematurely because it was feared that this type of treatment would cause increased risk of coronary heart disease, stroke, blood clots and breast cancer. Understandably, many women became skittish about taking any hormones at all for menopausal symptoms.
Until that study was halted, hormone therapy was thought to be a safe and effective treatment for menopause symptoms such as hot flashes, irritability, vaginal dryness and night sweats. Then, almost overnight, many stopped taking hormones altogether after they read the alarming headlines. Well, what’s the news since then?
A critical look at the WHI study shows that the women in that study were not really representative of menopausal women, after all. On average, the women in the WHI study were 12 years after menopause. Seventy percent were between 60 and 79 years old. Other factors such as the overall health of the women in the WHI study, the statistical methods used, and the choice of hormone therapy have been criticized, too. Another, better study, specifically designed to answer questions about how well recently menopausal women (age 40-55) tolerate hormone therapy is now being carried out, but we don’t have the answers from that study yet.
This much we do know: Women who start taking hormones closer to the onset of menopause apparently do not experience increased heart risk. And at least two studies show that combining estrogen and progestin may lower a woman’s risk of developing diabetes. Which means, if you are experiencing severe menopausal symptoms, don’t rule out hormone therapy. But you need to discuss your best options with your own health provider.
I recommend reading up on the pros and cons in advance. A helpful website that features a balanced view is the CBSCares menopause website, cbs.com/cbs_cares/menopause/index. The articles are written in a question and answer format that is easy to absorb. It features interviews with several menopause experts, who actually represent different views, which just shows how complex this topic is.
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If you want to consult someone who specializes in menopausal issues, I recommend going to the provider list of the North American Menopause Society website, menopause.org to find a local provider. And pick the recent book The Hormone Decision by Tara Parker Pope. As always, getting informed is the key to making good decisions for your own health.
Annette Owens, MD, Ph.D., is certified by the American Association of Sexuality Educators, Counselors, and Therapists. She sees clients in her Charlottesville office (cvillewellness.com) and answers questions online at LoveandHealth.info and SexualHealth.com. She has co-edited the new four-volume book, Sexual Health (Praeger).
