Glad to see that Angelina Jolie is publicly talking about her choice to have her ovaries removed to prevent ovarian cancer. She brings to light the important issues facing BRCA positive patients- including choices about surgery and its effect including premature menopause. I love that she says "health choices are a part of life, not to be feared". I think it is really important for patients to not be afraid to talk about their options and have all the medical information about their cancer risks. Check out the article here:
Results from a recent study support the idea that if hormone replacement therapy is given near the time that a woman enters menopause, that there is NOT an increase risk of cardiovascular risk. This data should reassure women that low dose, preferably trans-dermal menopausal hormone therapy is safe, effective and can help improve symptoms. Menopausal hormone therapy needs to individualized for each patient after a review of the patient's medical and family history, current health status and menopause symptoms. There is no one "correct" way to treat menopausal symptoms and I encourage women to consider their full range of options, from lifestyle and diet, over the counter supplements , to hormone replacement. There are many great options, and the bottom line is that you should not suffer with menopausal symptoms.
From the KEEP study-
KEEPS hormone therapy trial in newly menopausal women (September 2014)
The Women's Health Initiative (WHI), a set of menopausal hormone therapy (MHT) trials in older postmenopausal women (average age 63 years) reported an excess risk of coronary heart disease (CHD) with MHT. Emerging data, including secondary analyses from the WHI, now suggest that use of MHT in the early menopausal years is not associated with excess CHD risk. The Kronos Early Estrogen Prevention Study (KEEPS) is the first randomized trial of MHT in younger menopausal women (727 women ages 45 to 54 years) . When combined with cyclical monthly oral progesterone, low dose oral conjugated estrogen (0.45 mg daily) or transdermal estradiol (50 mcg daily) for four years relieved menopausal symptoms. While several markers of cardiovascular risk improved in the MHT group, there was no significant effect on surrogate markers of atherosclerosis progression (coronary artery calcium and carotid intima-medial thickness) when compared to placebo. This trial provides additional reassurance that early use of MHT is safe for the treatment of menopausal symptoms, though it does not support a role for MHT in prevention.