For women in their 50s, lower estrogen levels lead to menopause and a whole set of health concerns.
"This is the beginning of the aging process," says Kate Beadle, a Kaiser Permanente nurse practitioner who specializes in menopause.
Dr. Audrey Curtis, who's helping start a women's health clinic at Legacy Meridian Park, says: "A lot of women feel like they're on a roller coaster. Their hormone levels are doing what they did in the teenage years, really up and down."
For some women, the answer is hormone replacement therapy to deal with symptoms of menopause. But the 50-year history of HRT has been as wild as the mood swings it is supposed to prevent. And the changing recommendations for women, as well as cancer fears, have led to confusion and stress.
Introduced in the 1960s, long-term estrogen treatment was marketed as a wonder therapy to combat aging, disease and depression. Two 1975 studies indicating increased cancer risk made a temporary dent in sales, but it didn't last as other hormones like progestin were added to the therapy, supposedly eliminating the added cancer risk.
In 2002, a major study by the federal Women's Health Initiative made a much bigger impression, linking estrogen-based treatment and elevated cancer risk. And estrogen was not a miracle drug that prevented certain chronic diseases, contrary to an earlier study.
Since then, the Women's Health Initiative has been criticized for design flaws by medical researchers and other experts, and even its authors have backtracked on some of their warnings of elevated risk of heart disease.
In 2012, the U.S. Preventive Services Task Force issued a review of published research, including the Women's Health Initiative, and did not address the use of HRT to treat symptoms of menopause. However, it recommended against the use of HRT by post-menopausal women to prevent chronic disease.
The task force concluded:
Estrogen plus progestin and estrogen alone decreased risk for bone fractures.
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Women's health: Women in their 50s face changes, choices like hormone therapy
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