Health

Physicians and patients debate the benefits
and risks of hormone replacement therapy.

RUTHAN BRODSKY

Special to The Jewish News

T

aging hormones
for the next 25
years is a frighten-
ing thought for
middle-aged women. It's hard
to keep up with the medical
and alternative options for
treating symptoms and for
preventative health during
perimenopause and
menopause.
Adding to the confusion is
the sometimes contradictory
research literature.
Perimenopausal and
menopausal women are
encouraged by most physi-
cians to take hormones to
prevent osteoporosis, heart
disease, colon cancer, and
other diseases associated with
menopause and aging.
Debating whether or not to
take estrogen or increase one's
risk of a prolapsed bladder at
age 70 doesn't seem like a fair
choice.

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At the turn of the century,
a woman's average life
expectancy was 47. Today,
women can expect to live
almost half their adult lives
after menopause. There are
few role models for this kind
of aging. Women can't look
to their mothers to find
answers about what happens
after 15 years or 25 years of
medical treatment.
There are answers, but
they're not black and white.
The answers are personal, -
based on a woman's medical
history, her lifestyle, and
sometimes her medical insur-
ance. Moreover, answers are
likely to change as a person
ages and new medical
research is reported.
"At 46, my physician
talked about starting hor-
mone therapy but I wanted
nothing to do with it," says
Elaine Lippitt of Commerce
Township. "I was still men-
struating and I knew the risks
of osteoporosis but I assumed

my lifestyle was good enough
to deal with this risk in a nat-
ural fashion. I exercised, I
worked, I have a positive atti-
tude about life.
At age 53, Lippitt's life
changed. She stopped men-
struating and started having
hot flashes. "I became
moody; I wasn't sleeping,
and I was depressed," Lippitt
says. "I didn't like myself this
way and revisited my gyne-
cologist. We discussed
options and I started using a
prescribed combination of
estrogen and progestin."
Estrogen replacement
therapy (ERT) or using
estrogen alone is usually pre-
scribed only for women
who've had cancer of the
uterine lining (endometrial
cancer), which is not a possi-
bility when the uterus has
been removed.
Hormone replacement
therapy (HRT) uses estrogen
and progestin, a synthetic
that acts like progesterone,

and helps prevent endometri-
al cancer.
According to Dr. Dan
Benjamin, obstetrician and
gynecologist in Commerce
Township and Livonia, hor-
mone therapy often gets a
bad rap because women com-
pare it to their birth control
pill days and the increased
risk of blood clots and cancer.
"Only about 25 percent of
postmenopausal women
women actually are on hor-
mone therapy," says Dr.
Benjamin. "Some never fill
their prescriptions, some stop
after a short time, often out
of fear of cancer, and others
are afraid of the side effects,
such as regular bleeding.
"Yet the new hormonal
and nonhormonal treatments,
along with the growing
knowledge about the long-
term health benefits, have put
the questions of hormone
therapy at a new level."
After three months of hor-
mones, Lippitt was ready to