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Estrogen therapy "KEEPS" Going!

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Hormone therapy is still safe and beneficial for many women as they transition into and through the menopause. But you do need the right type of estrogen, and the right way to deliver it to your system. Now there are newer studies regarding the type of therapy, whether you should have a bioidentical therapy, the dosage of therapy, and the route of therapy. Estrogen therapy has to be individualized by your gyno to keep your benefit maximized and risks minimized. It’s important to still watch the research, but realize, there are many studies that say we can “KEEP” our patients on therapy. A new study is about to get as much coverage as the Women’s Health Initiative (WHI) regarding women in menopause and the use of hormone therapy. They studied many fewer women than in the large WHI study, the women were not studied for as many years, but it is very interesting data. The KEEPS study, which is the Kronos Early Estrogen Prevention Study, confirms benefits of hormone therapy, and while it confirms some of the risks it does try to put the risks of therapy in perspective. The study reports on 727 early menopausal women who were studied for 4 years. Specifically the researchers were most interested in their quality of life, their development of hardening of the arteries (atherosclerosis), their blood test markers of cardiovascular disease and various other outcomes. The KEEPS study also is looking at bone and breast health. Interestingly they also chose to compare oral estrogen, given as Premarin, to patch therapy, given as the Climera patch. There were some differences in effects of the oral and the patch therapy, but interestingly they could not demonstrate a clear benefit of transdermal therapy to taking a pill. Those gynos who practice menopausal medicine feel that the data is important, yet it’s not possible to know if this would hold up to all formulas and all dosages. Oral Premarin hormonal therapy had more benefit on cholesterol and inflammation as measured by C-reactive protein. Transdermal Climera patch therapy had more benefit on fasting blood sugar levels and insulin resistance.
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