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January 5, 2017

Fear of Estrogen Replacement Causes Suffering

By Jeffrey Dach

According to a Yale report, fifty thousand women died needlessly from fear of estrogen replacement after hysterectomy. Why does our medical system allow this needless suffering?

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Elizabeth Taylor from the trailer for the film Giant. 1956.
Elizabeth Taylor from the trailer for the film Giant. 1956.
(Image by (From Wikimedia) Trailer screenshot, Author: Trailer screenshot)
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According to a study by Philip M. Sarrel, fifty thousand women died needlessly from fear of estrogen replacement after hysterectomy.(3) Both Time Magazine and the LA Times declared 50,000 women's lives could have been saved.(3,4) Hysterectomy causes estrogen deficiency, a heath risk associated with increased mortality. Above Left Image Actress Elizabeth Taylor underwent hysterectomy, courtesy of Wikimedia Commons.

The Mortality Toll of Estrogen Avoidance

Dr Philip M. Sarrel says: "Estrogen therapy has been widely misunderstood, and may offer important benefits to women in their 50s who have had a hysterectomy." Watch a video from Philip M. Sarrel, MD, professor of Obstetrics and Gynecology at Yale Medical School.(3) This information is old news. Many medical studies over the years show hormone replacement (HRT) after hysterectomy reduces mortality and improves quality of life.

Bioidentical Estrogen Reduces Mortality After Hysterectomy

For example, Dr Parker followed 30,000 women over 24 years after hysterectomy. Half the women had ovaries removed and half had ovaries preserved. The group with ovaries removed had estrogen deficiency, and higher all-cause mortality rate. Therefore, Dr. Parker recommended ovarian preservation. Dr Parker also found that post-operative hormone replacement is very beneficial for reducing heart-disease risk in women after hysterectomy. (1)

In a second study, Dr Cathleen Rivera followed 1,000 pre-menopausal women, under age 45, after hysterectomy, and found that removal of the ovaries resulted in a disturbing 84% increase in death from heart disease. However, if these women were given estrogen replacement after ovarian removal, they were protected with a 35% decrease in mortality from heart disease.(2) I thought this was rather impressive.

Premarin Only for Women After Hysterectomy

The Second Arm of the Women's Health Initiative showed reduced mortality in the estrogen users after hysterectomy. (11) For the Premarin-treated post-menopausal women 50-59 years of age, the authors reported an impressive 27% reduction in mortality compared to placebo group. (11) The obvious take-home message is that estrogen replacement is beneficial for women after hysterectomy. Doctors who deny women estrogen replacement cause needless suffering and increased mortality.

Here is the quote from the 2011 JAMA Women's Health Initiative (8):

"Younger postmenopausal women (aged 50-59 years) who were randomized to Premarin estrogen (CEE) vs. placebo had a lower risk of death (HR, 0.73). Note: HR is Hazard Ratio. This represents a 27% decrease in mortality for the estrogen users compared to placebo users. (8)

Avoid Carcinogenic Synthetic Progestins

Synthetic versions of progesterone called "progestins" such as medroxyprogesterone (MPA) are known to be carcinogenic based on data from the 2002 Womens' Health Initiative First Arm.(12) This study was halted early because synthetic progestins increased the risk of breast cancer. For this reason, avoiding carcinogenic progestins is recommended. Instead, use natural human bioidentical progesterone having the same chemical structure as ovarian progesterone, made by the female ovary.

Dr. JoAnn Manson Editorial in NEJM

Dr. JoAnn Manson is in agreement with Dr. Sarrell. Here are a few quotes from Dr. Jo Ann Manson's editorial in NEJM 2016: (10)

Hormone Replacement is Effective, Yet Few Woman Are Treated

"Despite the availability of effective hormonal "treatments for menopausal symptoms, few women with these symptoms are evaluated or treated."

Leading Medical Societies Agree that HR Therapy is Effective and Should Be Recommended

Leading medical societies "agree that hormone therapy is the most effective treatment currently available for (menopausal) symptoms and should be recommended."

Yet 20% of Symptomatic Women in Early Menopause Remain Untreated

Yet, "20% of women in early menopause" remain untreated despite having symptoms that adversely affect their daily activities, sleep, and quality of life.

New Doctors Lack Training in Managing Menopausal Symptoms

The new generation of "primary care providers often lacks training and core competencies in management of menopausal symptoms and prescribing of hormonal "treatments."

Doctor's Reluctance to Treat Created Needless Burden of Suffering

"Reluctance to treat menopausal symptoms has derailed and fragmented the clinical care of midlife women, creating a large and unnecessary burden of suffering."(10)

Conclusion

We have known for decades the benefits of estrogen replacement after hysterectomy. Yet, thousands of women have been denied estrogen replacement by the medical system. Hopefully this message will resonate with our medical system so that we may avoid needless suffering in the future.

Author: Jeffrey Dach MD

Articles with Related Interest:

Bioidentical Hormones Found Beneficial After Hysterectomy

Bioidentical Hormones Prevent Osteoarthritis

Bioidentical Hormones Prevent Heart Disease

The Safety of Bioidentical Hormones

The Importance of Bioidentical Hormones

For references see original article.



Authors Website: http://jeffreydachmd.com

Authors Bio:

Jeffrey Dach MD is a physician and author of three books, Natural Medicine 101, and Bioidentical Hormones 101, and Heart Book all available on Amazon, or as a free e-book on his web sites.

Dr. Dach is founder and chief medical officer of TrueMedMD, a clinic in Davie, Florida specializing in Bioidentical Hormones, natural thyroid, functional medicine and low level laser therapy.

Dr. Dach was originally trained and board certified as an Interventional and Diagnostic Radiologist, and worked in the hospital setting for 30 years in Broward County at the Memorial Hospital System. Because of declining visual acuity, Dr Dach retired from radiology and returned to clinical medicine about 8 years ago when he founded the TruMedMD Clinic offering bioidentical hormones and natural thyroid to the South Florida region. For more information about Dr Dach, you can find his entire CV posted on-line on his web site.


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