Dr. Heward shares if a 55-year-old who went through menopause already continue to take hormones.
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Empowher Asks: Should a 55-year-old woman who went through menopause at age 50 take hormones? Dr. Heward: Fascinating question for which we don’t have a definitive answer. The reason is interesting is that there is some evidence to suggest that it's better to take hormone replacement therapy at the menopause and never go through a period where you are experiencing estrogen withdrawal. The reason for that is that the disease processes that seem to accelerate in the absence of hormones have a chance to get a foothold, and the estrogen may be less beneficial after a period of time when those disease processes have been progressing. That said there is also some evidence to suggest that at any point along the way, estrogen may still be beneficial. The concern is some preparations of estrogen, namely, orally administered estrogen, have a first-pass effect on the liver and, in women who have been without estrogen for a period of time since menopause. There may be atherosclerosis underway which is a bad thing to have if you’re going to take a prothrombic agent like estrogen orally. That said, you could take a transdermal estrogen and avoid that first-pass effect and, I would guess in the absence of solid data, nobody has studied it, that the protective benefits of estrogen would apply to even women who are many years postmenopausal as long as you take a formulation that avoids that first-pass effect on the liver.

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