1. Home>
2. Reader Remarks

Reader Remarks on:

"Timing Hypothesis" for Hormone Therapy: Still Viable, or Time to Let Go?

• Natural hormones
• combination or sequential HT?
• Retired Gynecologist--no guilt trip for me for replacing estrogen.

Natural hormones

Steven J. Meyerson, M.D., 18 Sep 2009 9:46 AM EST

Competing interests: None declared

It's too bad the use of semisynthetic hormones and estrogens from a nonhuman source (pregnant mares) has been generalized as "estrogen" or "hormone replacement therapy." Until studies are done with estriol, estradiol and progesteron in human ratios, we will not have any information at all on the value or dangers of "real" hormone replacement. We don't know whether there is a class effect or if outcomes are specific to the particular commercial hormone cocktail used in the studies.

back to top

combination or sequential HT?

E. Lerner, 18 Sep 2009 11:42 PM EST

Competing interests: None declared

I have been on HT since I started to go into early menopause maybe 10 or more years. I'm now 61. I don't see enough studies if any at all on taking the combo of estrogen and progestin vs sequential delivery which I have been on. A couple times a switched to a combination drug and it didn't agree with me at all. My unscientific, unproven, bias opinion has been that the body works on cycles and that the combination drug which might be more convenient is not a favorable way to deliver HT. I take HT now because I am a singer and want to maintain suppleness in my vocal cords as long as possible and b/c I have MS, diagnosed later in life; Some articles I have read suggest that estradiol (which I do not take) and perhaps estrogen could be good for people with MS.

back to top

Retired Gynecologist--no guilt trip for me for replacing estrogen.

Richard R Thornton, Retired, 22 Sep 2009 2:49 PM EST

Competing interests: None declared

Please read the abstract as well as the summary article to get actual numbers and statistical analysis

I prescribed hormone replacement for many women in the perimenopausal period during the 30 years I was in practice. I did not prescribe progestin except if a uterus was present. Then I used premarin .625 and norethinedrone sequentially. My wife was given the same therapy. Primarily this was prescribed to prevent osteoporosis. At that time the reported incidece of hip fractures was extremely high and biphosphonates were not available. Estrogen therapy was recognized as standard of care by academic gynecologists.

It is somewhat redeeming for me that in the Women's health initiative, the overall mortality was no higher in the treated group and in many instances, e.g. colon cancer, the incidence was actually lower. The absolute risk for coronary and for breast cancer is actually acceptible in my view for intermittnat therapy for vasomotor symptoms where by one can "wean" a woman off estrogen, now using estradiol rather than conjugated estrogen.

Another study using estradiol rather than conjugated estrogen is needed

back to top

Your Remark: