Dr. Melissa Wellons of the Multi-Ethnic Study of Atherosclerosis (MESA), funded by the NIH found that women who began menopause before the age of 46 y.o., had double the risk of cardiovascular disease in later life, regardless of other risk factors, race, ethnicity and whether the menopause was surgical or not. In another development, the Endocrine Society issued a formal statement that women age 50-59 y.o. have a 30-40% reduction in total mortality if they start hormone replacement therapy (HRT) and take it for 5 years compared to those who start the therapy in their 60’s or higher. The risk is almost all due to progestin therapy. Estrogen itself or mixed with bio-identical HRT (estrogen plus progesterone) does not appear to increase the risk of breast cancer. The usual cautions of individualizing the therapy and using the lowest dose for the shortest duration apply.
See Family Practice News(click here), July, 2010 issue, p. 36.