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Remember when Momma told you not to put things in your mouth?
Well, she was talking about estrogen pills - she just didn't know it.
Today - four years after the Women's Health Initiative found a distinct downside (breast cancer) to using Prempro (the estrogen/ progestin pill) in older women - even those rethinking hormones for younger women are still anti-oral estrogen.
That's because estrogen in pill form gets processed through the liver, and the side effects associated with those pills include the risk of cardiovascular complications.
That means possible blood clots and elevated levels of a cardiovascular risk factor called C-reactive protein.
This is an unnecessary tradeoff for better skin or a healthy vagina when there are other products available that can reach the same goals, says Dr. Alan Altman, an assistant professor of Obstetrics, Gynecology and Reproductive Medicine at Harvard Medical School.
Those products include gels, patches, creams, rings and tablets. Even drops put under the tongue are far preferable to pills, he says.
Altman is the author of a book whose information on oral estrogen he is even now repudiating.
(See Page 25 of Making Love the Way We Used to Or Better, $14.95, Contemporary Books.)
"The change of direction came as the WHI came out," he said following a lecture in Palm Beach, where signed copies of the book were given to guests.
"The book is copyrighted 2001, and it was written between 1999 and 2000. We were using different kinds of orals, but even then, we knew when a woman had a thrombotic event (blood clots), the answer (when using hormones) was always non-oral.
"Disregard (what is written in the book about) orals. That was written quite some time ago, and we've learned a lot more since then."
Altman said he has no plans to amend or rewrite the book, but is planning another book that will be published online in May or June with updated information.
The planned title is: The Betrayal of American Women, Don't Throw Away Those Hormones So Quickly.
"Once we get the online book out, that will correct all the older stuff in the first book. And there will be access to more people at less cost."
That he is a fan of hormone replacement for women younger than those in the WHI study (an average age of 63) is apparent in what he gave his wife when she had a premature natural menopause at age 36.
"She's been on hormone replacement since 36; that was 21 years ago,' he says.
She uses a vaginal ring that needs to be replaced every three months and slowly releases estrogen.
"I told her, 'Honey, I brought you a ring.' She got all excited," he says, joking.
"But when she saw what it was, she said, 'Instead of changing this (estrogen) patch (she was wearing), I can stick this thing in for three months? Great, give me two.' "
(C) 2006 The Palm Beach Post. via ProQuest Information and Learning Company; All Rights Reserved
