Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women's Well-Being and Lengthen Their Lives -- Without Raising the Risk of Breast Cancer (2024 Revised and Updated Edition)

by Carol Tavris

Of course there were a few contradictory studies—there always are in medicine—but by the year 2000, major journals, research institutions, and leading oncologists were coming to the consensus that estrogen did not increase the risk of breast cancer.

—In 1991, cardiologist Lee Goldman and statistician Anna Tosteson, both then at Harvard Medical School, wrote a lead editorial for the New England Journal of Medicine titled “Uncertainty About Postmenopausal Estrogen: Time for Action, Not Debate.” A consensus of epidemiological studies, they wrote, had shown that women who were given postmenopausal estrogen had a 40 to 50 percent reduction in the risk of coronary artery disease compared with women who had not taken hormones.11

After having a hip fracture, women lost an average of 3.75 years of life. Rather dramatically, the researchers calculated that if the women were fifty or younger at the time of the fractures, they would lose 27 percent of their expected remaining years; if they were over eighty, they would lose 38 percent of their expected remaining years.5

When women go off estrogen, the risk of hip fractures rapidly increases, and within six years it is where it would have been had they never taken hormones at all.

In a review of eleven studies of estrogen and hip fracture published since 1990, epidemiologist Deborah Grady and her colleagues at the University of California, San Francisco, found that all but one reported a reduction in the risk of hip fractures among women taking estrogen compared with nonusers. Again, the longer the women had been taking estrogen—ten years or more—the lower their risk of hip fractures.21

Currently, ERT or HRT is the most effective intervention with the fewest unpleasant or dire side effects for preventing or diminishing the development of osteoporosis. It has been repeatedly shown to reduce the risk of the condition’s most incapacitating complication, hip fracture, by 30 to 50 percent. In absolute numbers, this reduction is highly meaningful.