Menopause not the end of an active sex life
North American women are questioning the use of the Estraderm patch or an estrogen pill to combat menopausal changes.
Some women ask friends or neighbors about it, others seek guidance from their physicians. My advice: Why not be on the cutting edge and listen to the Society of Obstetricians and Gynecologists of Canada? Then your decision will at least be an informed one.
The society asked a select committee of gynecologists, endocrinologists, statisticians and others to analyse existing data on hormone therapy. The Menopause Consensus Committee then published its results.
Menopause does not mean the end of an active sex life. In fact, some women report an increased sex drive.
Estrogen replacement therapy can improve your sexuality in several ways, particularly by preventing senile vaginitis, a thinning of the vaginal lining that often causes painful intercourse.
Statisticians show that ERT also protects against cardiovascular disease, the No. 1 killer of women. Data proves that ERT can reduce the risk of coronary heart disease by as much as 50 per cent. This fact alone should make even the most skeptical woman sit up and take note. This protection applies at anage, but it is highest with more than 15 years of use. Moreover, contrary to previous beliefs, ERT is beneficial for women who smoke, have diabetes, hypertension, coronary heart disease or have had a heart attack. In fact, women who have coronary heart disease enjoy the greatest advantage of ERT.
Experts claim ERT benefits the cardiovascular system in several ways. It helps monitor fats in the blood, thereby decreasing the risk of atherosclerosis.
Estrogen also protects against coronary attack by dilating coronary arteries and keeping the lining of blood vessels healthy. And it makes blood platelets oily, so they’re less likely to stick together and cause a fatal blood clot. It also prevents the accumulation of abdominal fat. As we age, there’s a tendency for body cells to become resistant to insulin, increasing the risk of diabetes. Estrogen helps maintain the effectiveness of insulin.
The Menopausal Consensus Committee recommended the use of ERT to combat the epidemic of osteoporosis (brittle bones). In a woman’s lifetime, she has a one-in-six chance of sustaining a hip fracture and one-in-four of spinal fracture.
The decision to use ERT should be made quickly, once menopause has started. Why? Because this is when increased bone loss takes place. Fortunately, ERT can repair bone loss during the initial three years of menopause. The message is clear: Don’t lose this opportunity.
No evidence exists to suggest a magic age to stop ERT. In fact, there’s nothing to suggest it should be discontinued at all. As I often tell patients, my mother was taking estrogen at 93 years of age.
The majority of women who refuse ERT do so for fear they will develop cancer. That’s why I suggest you pay attention to what the experts say about ERT and cancer.
They conclude that the benefits of ERT outweigh the rare risk of its causing cancer of the uterus. And the addition of progestin reduces this risk even further. In fact, some studies show no excess deaths due to uterine malignancy.
The committee’s report goes a step further, contending that estrogen should not be withheld from women who have been treated for early cancer of the uterus or an ovarian malignancy. There is no evidence that ERT increases the risk of ovarian cancer.
The report states that women should not ignore other proven facts — for instance, oral contraceptives used during the reproductive years help protect against uterine and ovarian cancer.
What about breast cancer? Authorities contend that the use of ERT does not appear to significantly increase the risk of breast cancer. Nor are cystic breasts a contraindication for ERT.
Today, doctors stress the importance of preventive medicine. There are few better examples than ERT, because 25 per cent of women with a fractured hip die and 50 per cent never walk again, and half of heart attack patients never even reach the hospital.
Last, the Estraderm patch and estrogen pills affect the quality of life. They are proven to control hot flushes, insomnia, crying bouts and panic attacks.
The time has come for North American women to believe these facts.