Prior studies often suggested similar results. But not all of them did. Some showed no link between early menopause and greater fracture risk or shorter lifespan.
The researchers in the new study defined early menopause as no menstrual periods for 12 months before age 47. Late menopause was defined as occurring at age 47 or older.
The study, done in Sweden, began in 1977. All 390 women were 48 years old when the study began. Of these, 61 had early menopause and 329 had late menopause. By age 77, 198 of the women were alive and still in the study. Researchers were able to interview them and do bone mineral density studies.
Women with early menopause were almost twice as likely to have osteoporosis as women with late menopause. This disease causes brittle bones. Early menopause increased the rate of broken bones related to osteoporosis by 68%.
Only 48% of the women with early menopause were alive at age 77. Of the women with late menopause, 65% were still living.
The researchers were not able to find out why there was a greater risk of osteoporosis, fractures and early death in women with early menopause. But estrogen is well known to help strengthen bones.
The average age of menopause for the early group was 42. The researchers did not have the average age of menopause for the late group.
The average age of menopause in Western countries is 51. A woman who reaches menopause at 51 has had 9 more years of estrogen than a woman who reached menopause at 42. So she is starting the rest of her life with a much higher bone density than a 51-year-old woman with early menopause.
What Changes Can I Make Now?
The current advice is to use estrogen after menopause only to decrease symptoms. These symptoms include hot flashes, especially those that interrupt sleep, and dryness in the vagina. The estrogen dose should be the lowest effective amount for the shortest period of time.
New research suggests that the scare about estrogen treatment for some women after menopause may be overblown. Some studies have found that women taking estrogen-only treatment soon after menopause may actually have a lower risk of heart disease and breast cancer. Estrogen-only treatment means no progesterone. Taking estrogen along with progesterone increases breast cancer risk.
Women take progesterone with estrogen mainly to decrease the risk of cancer of the uterus. This is also called endometrial cancer. If a woman has had a hysterectomy to remove the uterus, progesterone is not needed. For women who have a uterus, there are ways to screen for early-stage endometrial cancer with ultrasound and biopsy. This provides an option for estrogen-only therapy. However, most gynecologists still recommend progesterone.
If you have early menopause, it's surely reasonable to consider estrogen treatment until age 50 or perhaps a bit longer to help protect your bones. That's an easy decision if you don't have a uterus. You can take estrogen without progesterone.
If you do have a uterus, things get more complicated. You will need to weigh the added risk of breast cancer with estrogen plus progesterone vs. the increased risk of endometrial cancer with estrogen only. Discuss the risks and benefits with your doctor.
No comments:
Post a Comment