Is Estrogen Out of the Doghouse?
A first-born graduating from sixth grade –- that’s a legitimate reason to get a little weepy. And when you tell a friend you’ve been crying about it and she starts quoting the Beatles “love goes on within you and without you” and you cry some more –- that’s no surprise, either. But tie all that crying to more crying –- in the office, out in the field -- in the shower even, and something is up. That something was, for me -- you guessed it -- perimenopause: hormones on a major rant.
I've never been as relieved as I was when my prescription for estrogen raised the clouds, stopped the hot flashes and generally made things better. It was so obvious that my kids called them my “happy pills.”
In the April 18th New York Times Magazine, Cynthia Gorney describes her own menopausal descent and (hormone-induced) resurrection –- and goes on to review the latest theories, studies and scary warnings on the safety of Hormone Replacement Therapy (HRT.)
Like other boomer women, I read those warnings and stopped the pills in favor of herbs. Ha. Like that was going to help. The moods returned -- and the hot flashes and the tears -– this time accompanied by terrible memory lapses and struggles to get my work done. So I went back, happily, to my estrogen.
It used to be tough to talk about these things –- too anatomical and too private. But now, we're talking about it on our blogs, like this one by Midlife Muse, we celebrate Menopause Month. And people like Sue Richards operate My Menopause Blog –- one of many. Even the Society for Women’s Health Research blog is getting into the act.
This is not, however, just a story about a couple of weepy writers and the pills that brought them back to normal. It’s also about a remarkable new area of research called “the timing hypothesis.” It draws a line between the older, post-menopausal women and those teetering on the edge of perimenopause. It turns out that those who start taking hormones as they begin to experience changes gain pretty substantial benefit from them. For those who start their course after menopause the opposite is true: Some of those scary warnings are for real. As Gorney describes:
The biggest difference between me and the W.H.I. women, though, has to do with age and timing. I started on the patches while my own estrogen, pernicious though its spikes and plummets may have been, was still floating around at more or less full strength. The average age of the W.H.I. women was just over 63, though the study accepted women as young as 50. More significant, though, most of them were many years past their final menstrual period, which is the technical definition of menopause, when they began their trial hormones. The bulk of the group was at least 10 years past; factoring in the oldest women, the average number of years between the volunteers’ menopause and their start on the trial medications was 13.4.
Gorney goes on to describe the advantages the medication has for our brains as we age. If our brains are healthy, it protects and supports. If they’re already failing, it hastens the process. As the research heroine of her piece tells her “ ... with estrogen, I don’t have attention deficit disorder.”
So. Once again things have changed. Estrogen the Evil has returned to something of an elevated status. Research may take it even further. A large majority of those with Alzheimer’s are women: sixty-eight percent. Could estrogen help their minds too? Dr. Roberta Diaz Brinton, a major player in Gorney’s story, believes there’s good reason to try to find out.
Let's review: Estrogen may be helpful for women whose treatment begins while they still have much of their normal hormone function and may be toxic to those whose treatment begins once menopause has arrived. When it works well, it helps with physical health, mood and memory. And, for women like me, it means no more crying on the 104 bus.