Healthy Living
Estrogen - Stroke Risk
By David Perlmutter, MD, FACN
Hardly a day goes by that we do not hear some new therapeutic claim supporting the contention that virtually all post menopausal women should take some form of hormone replacement therapy (HRT). While the statistics clearly indicate a beneficial response in women using hormone replacement therapy with respect to osteoporosis, the claims of the effectiveness of HRT in reducing the risk of Alzheimer's disease or cardiovascular disease are less well substantiated. Unfortunately, many clinicians continue to feel that menopause is some form of pathological event requiring medical intervention in the form of hormone replacement therapy and try to support the intervention with these often times not well substantiated therapeutic claims. Frequently the downsides of HRT, including the possibility of increased risks of certain forms of cancer, are understated.
In the past several years, the possibility that HRT may reduce stroke risk has become a topic of debate in the medical community. But in the study appearing in the November 1, 1997 issue of The Lancet, Danish researchers found that the risk of stroke in women using HRT was essentially identical to those who had not. In fact, transient ischemic attacks, or "mini strokes" were actually more frequent in women using HRT. At the conclusion of their report, the researchers speculated that their published results would lead to a re-evaluation of the effectiveness of hormone replacement therapy in general, and more specifically on its purported "beneficial effects" on the cardiovascular system.