The Estrogen Window: Anyone read it?

Sabine_Stroehm

I downloaded it from the Library. I'm about 1/2 through it. He makes a good case for using low dose estrogen with bioidentical progesterone just after menopause.

I'm still pondering. I'm using progesterone now. He claims using low dose estrogen just as menopause hits has MANY protective qualities that far out weigh the risks of estrogen. He also spends a lot of time "debunking" (really analyzing the flaws in) the WHI study that caused everyone to fear estrogen therapy.

If anyone else has read it, I'd love a discussion.

About me: I tend toward the natural, naturopathic, complementary approaches. I have NO regular prescriptions. I have an antihistamine on standby for sleep, and lorazepam on hand for really rough days. Otherwise, Melatonin, magnesium etc. And progesterone, and some herbs like chaste berry, evening primrose etc, and DIET have gotten me this far.

I haven't hit the 1 year period free yet, BUT I only bleed when on stressful work trips out of the country. I haven't had a "normal period since last spring or earlier. Latest LH of 45 and FSH numbers of 65 are VERY menopausal numbers. My numbers have been "menopausal" for couple of years. My OBGYN and GP refer to me as menopausal in all reports and our discussions. OBGYN says it takes some women's body's a while to catch up to what the hormones say. :-)

Primary symptoms all along have been: vertigo, tinnitus, edginess/crankiness, INSOMNIA, migraine. Some night sweats. NOW some hot flashes, but very manageable.

Again, I'd love to discuss the notion of the "estrogen window" as Dr. Mache Seibel conceives of it, and what it means for each of us. Cheers.

TheGaudyMagpie

I haven't read that book but I've likely looked at a lot of the same evidence. Analysis of a lot of different studies seems to indicate that all cause mortality rates are lower in women (on HRT vs. not) that start estrogen early in menopause and that the risks don't kick in for a few years after that. Most recently I read that the risks are similar to those who keep menstruating and reach menopause later. In other words, I'd be in a similar position if I'd simply gone through menopause later.

At 47, I was young enough that there were concerns about bone and heart damage from low estrogen that outweighed the risks of being on estrogen. On top of that, I believe that my increase in activity had a significant positive impact on my health that would offset the small risk (and the risk is very small in context) that HRT might pose, and the change in fat pattern from the center of my abdomen to my lower body would also have a positive impact.

Of course there are women with pre-existing issues that increase the risks, but for a healthy woman with a relatively healthy lifestyle, I believe the risks are minimal and are outweighed by the positives.

I'll take a look at the book as it sounds interesting.

Edit: I have theories, by the way, of why HRT for women is looked at so negatively. Does he talk about any of the social forces that surround its perception?

Sabine_Stroehm

TheGaudyMagpie wrote: »

I haven't read that book but I've likely looked at a lot of the same evidence. Analysis of a lot of different studies seems to indicate that all cause mortality rates are lower in women (on HRT vs. not) that start estrogen early in menopause and that the risks don't kick in for a few years after that. Most recently I read that the risks are similar to those who keep menstruating and reach menopause later. In other words, I'd be in a similar position if I'd simply gone through menopause later.

At 47, I was young enough that there were concerns about bone and heart damage from low estrogen that outweighed the risks of being on estrogen. On top of that, I believe that my increase in activity had a significant positive impact on my health that would offset the small risk (and the risk is very small in context) that HRT might pose, and the change in fat pattern from the center of my abdomen to my lower body would also have a positive impact.

Of course there are women with pre-existing issues that increase the risks, but for a healthy woman with a relatively healthy lifestyle, I believe the risks are minimal and are outweighed by the positives.

I'll take a look at the book as it sounds interesting.

Edit: I have theories, by the way, of why HRT for women is looked at so negatively. Does he talk about any of the social forces that surround its perception?

It hasn't talked about the social forces yet, but more talked about how flawed the WHI Prem-Pro study was.

If you are somewhat electronically minded and in the U.S., many Public libraries have a new (NEW) service called Hoopla that has many more electronic books. The Estrogen Window was available both in audio and ebook format.

MostlyWater

I'll look for that. Thank you.

Sabine_Stroehm

I finished it. I enjoyed it, and bought the Kindle version. I'm re-reading it now.

ronjsteele1

Good info! <adding to my reading list>

TheGaudyMagpie

I see a doctor outside of my usual provider network for dermatology/aesthetics stuff (skin tags, capillaries, botox) and his primary practice is as an OB/Gyn. He brought up the window the last time I saw him and he is a huge advocate of HRT. He believes that taking HRT in the window leads to better health and helps prevent dementia. He says that our bodies are meant to utilize hormones to work effectively and that it's just another thing that's become appropriate due to our living longer, like knee replacements.

We talked about herbal supplements and he does not support them in his practice because of a lack of quality control. There's no way to measure how much of that particular herb is in that supplement and studies have shown that it really does vary from what's on the label. In general there's a lack of data about effectiveness and risk. He believes it's just better to use HRT, which is measured and is generally safe for reasonably health people, especially when started early in the process.

Sabine_Stroehm

TheGaudyMagpie wrote: »

I see a doctor outside of my usual provider network for dermatology/aesthetics stuff (skin tags, capillaries, botox) and his primary practice is as an OB/Gyn. He brought up the window the last time I saw him and he is a huge advocate of HRT. He believes that taking HRT in the window leads to better health and helps prevent dementia. He says that our bodies are meant to utilize hormones to work effectively and that it's just another thing that's become appropriate due to our living longer, like knee replacements.

We talked about herbal supplements and he does not support them in his practice because of a lack of quality control. There's no way to measure how much of that particular herb is in that supplement and studies have shown that it really does vary from what's on the label. In general there's a lack of data about effectiveness and risk. He believes it's just better to use HRT, which is measured and is generally safe for reasonably health people, especially when started early in the process.

Great reply.
I've said it before here, but will repeat it again:
I *had* a lovely ObGyn who was great for my yearly exam, but for whom menopause was purely a theoretical construct. (ha). She didn't have much to offer.

So, I shopped around for another ObGyn to work with me at the later part of my peri-menopause, and into menopause.

The first one I "interviewed" was VERY much in support of HRT, (but was too dogmatic for my taste). She said she was in her 70s and said she'd "never gone through menopause" (hyperbole), because she couldn't afford to, didn't have time for it, and needed her brain (her words). She said estrogen would solve ALL my problems. Again, she was just a bit too dogmatic for me.

The second one I interviewed was also much older. We had a conversation. It was very open, and helpful. She recommended bio-identical HRT as well. Specifically, she recommended Prometrium and Estrogel (or a patch). Given where I was in the transition at that time, we compromised and I kept using bio-identical progesterone, but she recommended adding bio-identical estrogen when I was ready.

I asked her what she did: she said bio-identical HRT.

Both doctors had xeroxed copies of reports and studies addressing HRT, concerns, the PremPro studies etc., as well as reports and studies discussing the benefits and risks of HRT.

My last FSH was 65 (LH 46) and it's been many months since I've had a regular period (I tended to bleed when I travel, oh joy, but even that has not happened the last few trips). I'm going to make a follow up appointment with the new and mellow doc, and discuss my symptoms as they are now, and "The Estrogen Window" among other things.

ps: my mellow doc didn't have much that was positive to say about supplements other than DHA/EPA (oils), for much the same reason.