Dr. Zorba Paster: Hormone replacement might be worth risk

Back in the 1990s, we invited every woman of menopause age to take hormone replacement therapy (HRT), as it gave promise of a longer, sweeter life. We thought there would be fewer heart attacks (we were wrong), fewer blood clots (wrong again) and fewer strokes (strike three, were out).

The monumental Heart and Estrogen/Progestin Replacement Study (HERS) showed that when we thought we were helping we were actually hurting. This resulted in a dramatic drop in the use of estrogen-containing products.

But now the question is how to help a woman who has intolerable menopause symptoms. A so-called natural cure using the herb black cohosh has been a bust well-controlled scientific studies have not shown its worthwhile, even though the supplement producers disagree.

Anti-depressants offer some relief, but its minimal. When I was a medical student, believe it or not, valium was considered to be a viable treatment.

The dose I was taught was 10 milligrams of valium four times daily thats enough to keep a race horse from complaining.

The fact of the matter is HRT still has its place. For some women it might be used for just a few months and for others a couple of years. It has a risk, but the risk is like being on the birth-control pill.

If you dont smoke, if you exercise, eat a Mediterranean diet, keep your blood pressure in check and your cholesterol is under control, the risk from HRT has been minimized. In other words, think of the heart attack risk as a sum of all the risk factors and not just HRT.

With that in mind, a recent study published by the Journal of the American Medical Association, in JAMA Internal Medicine, is very exciting.

In Seattle, 400 menopausal women took one of two estrogen compounds. One was Premarin the first, most common and oldest estrogen compound, first introduced in 1942.

This compound, distilled from the urine of pregnant mares, is the gold standard. My mom used it back in the 1960s. She called it her anti-sweat pill.

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Dr. Zorba Paster: Hormone replacement might be worth risk