Q. I am totally confused about hormone therapy. I used to take Premarin to keep my bones stronger and reduce the risk of a heart attack. Then a friend who is a nurse pleaded with me to stop taking hormones because they can cause breast cancer.

Now I am suffering joint pain as well as hot flashes. I would like to go back on Premarin, especially since I just heard it is good for the heart after all. Do you have any information that will help me?

A. There is no more controversial topic than hormone replacement therapy (HRT). For decades women were told that estrogen and progestin could keep bones strong and hearts healthy. Then a large study (Women’s Health Initiative) cast doubt on the benefits of HRT. Women were told that these hormones could increase the risk of breast cancer and heart disease.

A new analysis of this research reveals that women in their 50s who had hysterectomies and were only taking estrogen had less calcified plaque in their heart arteries. Although this is somewhat reassuring, HRT still poses a risk of breast cancer.

We are sending you our Guide to Estrogen: Benefits, Risks and Interactions for more details on this controversy and some non-drug ways to cope with hot flashes. Age seems to be a critical factor in HRT safety. Older women, beyond 60, may be at increased risk for heart attacks and strokes.

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  1. Elise

    Bioidentical hormones have not been mentioned here that I can see. I take them and feel they’ve made a big difference in my overall physical & mental health. I’m 51 and without them I was having hot flashes and irritable all the time. My family has noticed the biggest difference in me since I started on them 2 years ago. These hormones are PLANT derived and are not the same as projestin and other premarin.
    Although many in the traditional medical community are against these bioidentical hormones, it’s becoming evident that American women are finally waking up and realizing these are safer to take, no side effects and improves our overall sense of well-being. If you’re reading this please consider looking into these instead of the traditional HRT medications.

  2. Noemi Weil

    I was taking HRT for about
    ten years. In September 2002
    I developed breast cancer. This was discovered from a routine mammogram. I was lucky that it was found early but I still had to go through chemo
    and radiation treatments. It
    will be five years this September. If HRT was
    responsible for this my doctors couldn’t say for sure. My two sisters took
    HRT [but no longer] and didn’t get breast cancer.
    I suppose it would be best
    to eliminate taking HRT….just in case.

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