A MENOPAUSE BREAKTHROUGH

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This is one of my favorite passages in “The Estrogen Fix” by Dr. Mache Seibel.

  

— The confusion from the WHI study left me wondering what other studies, clinical trials, and information revealed about the positive versus negative effects of estrogen. I started reading all the estrogen information I could find to understand why estrogen continued to be the 800-pound gorilla in the room for menopause, women, and their doctors. I analyzed years of data, poring over major and minor studies and hundreds of peer-reviewed journal articles and papers presented at meetings and symposia. I interviewed fellow experienced doctors and top researchers, including Drs. Pauline Maki, Phil Sarrel, Wulf Utian, Isaac Schiff, Mary Jane Minkin, JoAnn V. Pinkerton, JoAnn E. Manson, James A. Simon, Sara Gottfried, Andrew Kaunitz, and others as editor of The Hot Years-My Menopause Magazine.

I did this because menopause is one of the most challenging periods in a woman’s life. As an ob-gyn and menopause expert, I witness on an almost daily basis how menopause symptoms affect the quality of my patients’ lives and their performance in the workplace. Surely there had to be some evidence-based way that estrogen could be used to bring relief.

Each article, presentation, and interview contained a golden nugget of information that together created a pot of gold—something really valuable to help Sharon, my patients, and women everywhere. I came to realize there is such a thing I call the estrogen window, the time in a woman’s life when she can most safely take estrogen and benefit from it in many ways.

Consider the hormone insulin for a diabetic patient. Taken at the right time, insulin regulates blood sugar, keeps diabetes under control, and wards off potentially devastating side effects. If insulin is given at the wrong time, a diabetic can go into diabetic shock. For estrogen, too, timing is very important. As a medication, it is not about being either good or bad. It’s all about the timing. If taken at the right time, estrogen provides dramatic relief for the most troubling menopausal symptoms while at the same time providing a host of benefits, including:

— Extended protection from heart attacks and heart failure

— Reduced risk of Alzheimer’s disease and other forms of cognitive

decline

— Reduced risk of osteoporosis

— Beneficial cosmetic effects on the structure and resiliency of the skin

— Relief of sexual problems such as vaginal dryness and painful intercourse

— Relief from troubling and sometimes disabling hot flashes

— Improved quality of sleep

—Stabilized mood, particularly in women who have a known mental health diagnosis

— Lowered risk of type 2 diabetes

— Support for bladder tissue and lower risk of recurring urinary

tract infections

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Taken during a woman’s estrogen window, estrogen accomplishes all these astonishing feats with minimal increased health risks. How long her estrogen window stays open depends on two things: which estrogen-containing medicine is used and which symptom or condition is being targeted, which I explain throughout The Estrogen Fix.

If the same woman takes the same drug after her estrogen window has closed, there may be an increased risk of serious side effects. Her odds for developing cardiovascular disease, blood clots, cancer, and cognitive decline become higher. But remember: It’s not the estrogen that is bad; it’s the Provera combined with the estrogen and when it is taken during a woman’s life, or the timing, that are bad.

Too many women believe they have to struggle through this phase of life without assistance, and somehow if they do that and forgo estrogen, they will come out on the other side without any consequences. Others think that if they take estrogen and get almost immediate symptom relief, they will be diagnosed with breast cancer or heart disease a few years down the road. Nothing could be further from the truth. The Estrogen Fix will help you “figure it out” so you won’t have to “tough it out.”

It’s ironic that the treatment women have avoided because they fear increased odds of developing a dreaded disease is in fact the very treatment that can offer greatly expanded protection against developing those same potentially deadly conditions after menopause. The key to using estrogen successfully is to take the right estrogen and to take it at the right time for at least 5 to 7 years following the onset of menopause.

If you’re like my patients, you probably have a lot of questions: Is estrogen really as safe as you say? Do I take pills, use a cream, or apply a patch? What’s the right dosage for me? When should I start? How do I know when to stop? Which estrogen should I take? Which progestogen should I take? All your questions will be answered in The Estrogen Fix, so you’ll be prepared to have an informed conversation with your physician or health-care provider.