Would the doctor prescribe estrogen if my ovaries were removed because of cancer?
No. If there is any sign of a cancerous condition, estrogen would probably not be prescribed.
What is the estrogen controversy?
Estrogen is a female hormone produced by the ovaries. Scientists have also developed chemical estrogen. Both regulate the development of female sexual characteristics. For a number of years, estrogens have been prescribed for women during and after menopause to make up for the decline in this hormone normally produced by the ovaries. Estrogen has been found helpful in relieving symptoms associated with menopause, such as hot flashes, in overcoming drying of vaginal tissues and in retarding osteoporosis (thinning of bones). However, the use of estrogen during and after menopause has been linked to an increase in endometrial cancer (cancer of the lining of the uterus), and it may be linked to other cancers as well. At this time,scientists do not agree about whether the risks of taking estrogen outweigh its benefits.
If the doctor prescribes estrogen therapy for my postmenopausal symptoms, should I expect to continue taking estrogen forever?
No. Patients who are using estrogen therapy should have a thorough physical checkup, including breast and pelvic examinations, before starting estrogen therapy and every 6 months thereafter. You should also examine your breasts monthly for lumps or changes in appearance that may be warning signs of cancer. You should be sure to ask the doctor to reevaluate the situation at each examination. The doctor will probably have you take estrogen for part of the cycle and progestin for the remainder. The lowest dose possible is usually prescribed, depending on the circumstances of each individual case.
What are the risks of taking estrogen?
Studies have shown that women taking estrogen for menopausal symptoms have roughly a 2 to 8 times higher risk of developing endometrial cancer than women who do not take estrogens. The risk increases after 2 to 4 years of use and seems to be greatest when large doses are taken. Therefore, it may not be wise for women who have already had endometrial cancer to take estrogen.
If I have had my uterus removed, am I still at high risk for developing uterine cancer?
No. A woman who has had her uterus completely removed that is, someone who has had a total hysterectomy is in no danger of developing uterine cancer.
Is there any link between estrogens and breast cancer?
There is conflicting evidence on this question at this time. Some studies have suggested that use of estrogen, either during or after menopause, may increase breast cancer risk for some groups of women, but other studies do not show such a relationship. Women who are already at high risk for breast cancer for other reasons may further increase their risk of developing it if they take estrogens. In addition, any woman who has had cancer of the breast should not take estrogen for menopausal symptons.
Are there problems with using vaginal estrogen cream?
I am using it to relieve vaginal dryness that has accompanied my menopause. The warning about the increased risk of uterine cancer related to the use of postmenopausal estrogens for prolonged periods does include the vaginal creams as well as the estrogens taken by mouth or injection. Estrogens are manufactured in several forms, including tablets for oral application, liquids for intravenous and intramuscular injection, and vaginal creams for external application. They can be manufactured synthetically in the laboratory or derived from animal sources. Estrogens, whether naturally occurring, animal derived, or man made, presumably have similar benefits, side effects, and risks associated with their use. You should discuss the questions of estrogen replacement with your doctor. The two of you can decide whether continued use of the cream is advisable in your particular situation. Your doctor will probably advise you to take the lowest dose that will control the symptoms and attempt to discontinue the medication or decrease it at designated intervals.
The effect of estrogen on the brain.
Does a face cream that contains estrogen cause cancer?
Hormone creams have to be carefully used, and your own individual situation should be discussed with your doctor. Estrogen in the cream can be absorbed into your body. The action once in the body is the same as if you had swallowed a pill by mouth. Use of this kind of cream is not advised for anyone with a history of cancer.
Aren't estrogens good for preventing bone loss?
There is evidence that estrogens prevent bone loss and perhaps fractures in postmenopausal women. Some doctors feel that women who are at high risk for bone loss should be given estrogens as preventive medicine. The individual doctor and patient must weigh the risks against the benefits.
Side Effects Of High Estrogen | High Estrogen Symptoms
Is it true that the FDA has put warnings on estrogen products?
Because estrogen has been associated with endometrial cancer, the Food and Drug Administration (FDA) requires that a special brochure about the drug accompany each prescription for it, with the following warnings:
• There is probably an increased risk of cancer of the uterus if a woman uses estrogens for more than a year in treating symptoms of menopause.
• Patients should have their estrogen treatment reevaluated every 6 months.
• Estrogens should not be taken by women who have cancer of the breast or of the uterus, who have undiagnosed abnormal vaginal bleeding, or who have clotting in the legs or lungs.
• Estrogens should not be used in treating simple nervousness or depression during menopause, because it has not been proved effective for those purposes. Nor has it been proved that estrogens keep the skin soft or help a woman feel young. The brochure also recommends that users of menopausal estrogen be monitored closely by their doctors, that they use estrogen for only as long as necessary, and that they take the lowest dose that will control symptoms.