Top 10 Reasons You Need to Understand Your Estrogen Window

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E is for Estrogen (also Ellen).

Is estrogen a friend or a foe?  Are you confused???

No need to be, says Dr. Mache Seibel the author of the new book, The Estrogen Window, The Breakthrough Guide to Being Healthy, Energized, and Hormonally Balanced -Through Perimenopause, Menopause, and Beyond coming out April 12, 2016. Dr. Mache Seibel is a global leader in women’s wellness and menopause. He was a member of the Harvard Medical Faculty for 20 years and currently a Professor at the University of Massachusetts Medical School.

I receive hundreds and hundreds of emails from women all over the world (thank you, social media) who are scared to death to take any kind of hormone therapy (HT). Consequently, they are suffering with a myriad of menopausal symptoms such as insomnia, brain fog, hot flashes, emotional ups and downs, depression, migraines, vaginal dryness, weight gain, mood swings, anxiety – just to name a few.

While I love a good hot/sexy romance novel, you can see why I was equally as excited to be asked to read Dr. Seibel’s unedited manuscript.

Most women, are not aware of the latest studies, the different kinds of HT (all HT is not created equal) or the window of opportunity for taking estrogen that quite possibly could help prevent serious medical conditions later in life. Sadly, many women are still basing their healthcare decisions on what Dr. Seibel calls, “estrogen myth-conceptions.”

Before we get into the reasons why we need to understand our “estrogen window.” I want to share a little bit of estrogen history which Dr. Seibel explains in an easy to digest format!  Granted, it’s not sexy or hot, but it is really important background knowledge and will help us all understand why many women are still afraid of HT!

Here are some tidbits that I learned from The Estrogen Window:

The FDA approved estrogen Premarin in 1942.  By the late 1960’s it was the most prescribed drug in the U.S.  Then, in 1975 and 1976 a series of three articles from three different centers were published in the New England Journal of Medicine that proved that estrogen alone given to women with a uterus for long periods of time caused uterine cancer. It was then that the public opinion turned against estrogen.   In 1980 evidence was growing that showed estrogen was helpful in preventing heart attacks in women.  Remember, heart disease is the #1 killer of women, not breast cancer.

In 1995, The PEPI study (Postmenopausal Estrogen/Progestin Interventions) Trial reported that Premarin plus Provera had a positive effect on HDL (the good cholesterol) and it protected the uterine lining cells from cancer.  So, the FDA approved Provera to prevent cancer of the uterine lining in post-menopausal women. 

Then in 1990 the WHI (Women’s Health Initiative) was created.  In 1991, the WHI and the NIH (US National Institutes of Health) began a “gold standard” study which involved 161,808 post-menopausal women. There were two parts of the study.  The study was supposed to continue for 15 years.

  1. Estrogen Alone – commonly referred to as ET (estrogen therapy) They used conjugated estrogen in the study. (ET sold as Premrin.)
  2. Estrogen with Progestin – commonly referred to as EPT (estrogen plus a hormone that acts like progesterone) They used conjugated estrogen (Premarin) with synthetic progesterone medroxyprogesterone acetate (MPA sold as Provera).

After 5.2 years, in 2002 the study was abruptly shut down, because there was preliminary data indicating a small, measured increase in risk of breast cancer and cardiovascular heart disease among women who took Prempro. Dr. Seibel explains since this was a prevention study, any increased health risk required that it immediately be discontinued.

You can understand why so many women went into a panic – all they heard was breast cancer and heart disease.  No one took the time to read the fine print.

Dr. Seibel goes on to explain, “We now understand that the WHI study had serious flaws!  First, they compared a placebo group of mostly younger women (50-59 years old) to a study group of mostly older women (60-79 years old)! To make matters worse – the older group of women contained women who were lifetime smokers, and who already had heart disease”!

I am not a scientist or a doctor, but even I know this was a flawed study. Too many pre-existing factors that no one talked about!

In a previous blog, Dr. David Katz, the Founding Director of the Yale University Prevention Research Center, pointed out that the follow up of the study showed that there were holes in its findings—potentially life-threatening holes. A follow-up analysis in 2004 showed a reduction in mortality risk among WHI participants who had undergone hysterectomy and were treated with estrogen alone. What’s more, another follow-up review of the WHI in 2011 confirmed a decreased mortality risk of 13 per 10,000 per year among women 50 to 59 with hysterectomies who took estrogen. It also found that estrogen decreased rates of breast cancer and heart attacks by 23 percent and 50 percent, respectively.

Now that we all understand the history, I asked Dr. Seibel to give his top 10 reasons why women need to understand their estrogen window.  Here is what he told me:

  1. To remove the confusion about taking estrogen
  2.  To remove the fear about taking estrogen
  3.  To know when to start taking estrogen
  4.  To know when to stop taking estrogen
  5.  To know if it is too late to take estrogen
  6.  To know how much time you have to protect each organ and what your options are if you missed your estrogen window or choose not to take estrogen
  7.  To know there is a difference between estrogen alone vs. estrogen and progestogen
  8.  To know there is a difference between taking vaginal estrogen and oral or topical estrogen
  9.  To be better informed when you talk to your doctor or healthcare provider
  10.  To be able to help not only yourself, but also your friends and your family as a messenger so that they are getting the best treatment for the right reasons at the right time
  11. Do you know your estrogen window?

Hurry and pre-order The Estrogen Window so that you can start basing your healthcare on facts instead of fear! When your pre-order, you get to take advantage of the many wonderful free bonuses.

Suffering in silence is OUT! Reaching out is IN!

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • Thank you Ellen! I AM that woman (hysterectomy). This was comforting to read.

  • After surgical menopause I was so afraid to take hormones that my doctor let me read a PowerPoint presentation he had given to his Residents at Maimonides Hospital in Brooklyn. I desperately needed hormones as my symptoms, especially hourly nite sweats and hot flashes, destroyed my quality of life. Thank God I have a doctor who is a Menopause Specialist and knows his stuff. Even so, I still got a stress stomach ache the first night on hormones! The fear is horrible. I hope more and more information is published on this subject to dispel the myth so women don’t suffer needlessly. Thank you Ellen!

    • Thanks for sharing, Jacqueline. You are so right, thank goodness you were going to a doctor who was knowledgeable on the risks vs benefits of HT for surgrical menopause patients! Bravo!!!

    • lynn

      i am so confused. i have gained so much weight cant sleep at nights. Get flashes when i get stressed or drink tea or coffee. Get brain fog often.
      My GP doesnt seem to understand.

  • It seems incredibly complicated to dig out what the safest thing is. I’m glad that my effects are manageable without meds. They’re almost negligible, thank God.

    • You are lucky, Carol. It would be great if we could erase all the info we received from the initial reporting of the WHI. The study was so flawed. Dr. Seibel dissects the flaws one at a time and then gives us proper science to replace it. I think this book will help many women!

  • Lisa_GrandmasBriefs

    I had no idea I needed to worry about the window, too. I must say, I am so uneducated about estrogen, which is horrible. YOU have been tremendous help… but I clearly need more. Thank you for the reminder to get on top of this and have a REAL discussion with my doctor.

    • No worries, Lisa. You are in a big club! That is why I am here interviewing the experts so that we can all learn how to be our own health advocates! Just speak with your menopause specialist about it. If your doctor doesn’t know anything about this, then find another one who is up on the latest information!

  • doreenmcgettigan

    I agree with Lisa. I need more info so thank you. My mother and grandmother both got breast cancer after HRT, neither of them ever smoked so I have been spooked.

    • Your family history is an important part of the conversation with your menopause specialist. I would assume that your mother and grandmother were probably on the non-bioidentical HT. Like the women in the WHI study. It’s important to note, that the women in the WHI study who were on estrogen alone had a decrease in breast cancer. It was the non-bioidentical progestin (specifically medroxyprogesterone acetate) that caused the slight increase in breast cancer. There are many different forms of HT today. I will have more on HT in a future blog with Dr. JoAnn Manson who was one of the investigators of the WHI. So, stay tuned!

  • Lois Alter Mark

    I had no idea there was an “estrogen window.” I would know nothing about this whole crazy menopause without you, so thank you!

    • Thanks Lois. I try to find the smartest experts to help us all understand how to stay healthy and happy in menopause and beyond! Stay tuned for more info to come! In the meantime, if you are having a lot of menopausal symptoms – be sure to speak with your doctor about our estrogen window!

  • There is always one in the group and I am it who can not take any estrogen because I had breast cancer, estrogen positive. So what do I do, besides miss my estrogen, that is it!

    • Just stay on top of your overall health. Having your lipid profile done, bone density checked…. you are in great shape Haralee! You take wonderful care of yourself. No worries!