This is especially relevant for those of us with EDS because it seems to react to fluctuations in progesterone and estrogen. Some of this extra pain might be controlled by appropriate hormone therapy.
Hormone replacement therapy for women may not be as potentially risky as previously thought, a new Mayo Clinic review contends.
The new study, which evaluated three decades of prior research, concluded that hormone therapy to treat symptoms of menopause doesn’t increase overall risk of death or the risk of death from heart attack, stroke or cancer.
“This is the latest update of the current evidence,” said lead author Dr. Khalid Benkhadra, a research fellow at the Mayo Clinic in Rochester, Minn. “I can say there’s no risk of dying from any reason because a woman is taking hormone replacement therapy.”
The results, Benkhadra said, should allay concerns of some women with debilitating menopausal symptoms who have feared taking hormones.
But not everyone is sold on the safety of hormone therapy. Heart and cancer doctors who reviewed the new findings said that hormone therapy should still be used sparingly on those most in need, until further research proves otherwise.
“This study may provide some comfort that it shouldn’t shorten your life, but it doesn’t change the concern that the bad effects of hormone therapy are going to be an issue,” said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.
Lichtenfeld added that the review’s results are preliminary, and haven’t been subjected to the rigorous peer review necessary for a study to be published in a medical journal.
The Women’s Health Initiative found that hormone therapy using estrogen and progestin increased a woman’s risk of heart attack, stroke, blood clots and breast cancer, compared with placebo. Estrogen alone increased risk of blood clots and stroke, but made no difference in heart attack risk and had an uncertain effect on breast cancer.
The new Mayo Clinic study combines the data from 43 randomized, controlled trials on hormone therapy. The trials included more than 52,000 women. All were 50 or older.
Researchers found that neither of the main hormone therapies — estrogen alone, or estrogen combined with progesterone — affected a woman’s risk of dying from any cause, or specifically from a heart attack, stroke or cancer.
“We just summarized the current evidence, and came down to the conclusion there’s no significant effect,”
Hormone therapy has a complex balance of benefits and risks
hormone therapy reduced women’s risk of fractures, colorectal cancer and diabetes in the WHI, even though it increased risk of other potentially fatal conditions, Manson said.
We really recommend personalizing the hormone therapy decision-making process to the underlying risk factors of each woman,
More and more, we are finding that medication must always be personalized to be more effective and reduce side effects.
The North American Menopause Society Statement on Continuing Use of Systemic Hormone Therapy After Age 65
The 2012 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) states that hormone therapy (HT) is the most effective treatment for symptoms of menopause
To maximize safety, the initiation of HT should be considered for healthy symptomatic women who are within 10 years of menopause or aged younger than 60 years and who do not have contraindications to use of HT.
Contraindications are well established and should be considered in making this decision. However, vasomotor symptoms persist for an average of 7.4 years and for more than a decade in many women. Moderate to severe vasomotor symptoms have been documented in 42% of women aged 60 to 65 years.3 Thus, many women will continue to have vasomotor symptoms after age 65, and these symptoms can disrupt sleep and adversely affect health and quality of life
Provided that the woman has been advised of the increase in risks associated with continuing HT beyond age 60 and has clinical supervision, extending HT use with the lowest effective dose is acceptable under some circumstances, such as for the woman who has persistent bothersome menopausal symptoms and for whom her clinician has determined that the benefits of menopause symptom relief outweigh the risks
Use of HT should be individualized and not discontinued solely based on a woman’s age. The decision to continue or discontinue HT should be made jointly by the woman and her healthcare provider.
Hormones are entangled with both chronic pain and opioid treatment:
- Hormone Treatments in Chronic Pain
- New WHI Analysis: This Time Estrogen Saves Lives
- Hormone Testing and Replacement In Pain Patients Made Simple
- Opioids Disturb Hormones, but Function Improves
- Hormone Abnormalities in Uncontrolled Chronic Pain Patients
- Dual-hormone Therapy Reduces Pain and Opioid Use
- Hormone Therapies: Newest Advance in Pain Care
- Neuro-hormone implications for pain, stress, depression