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Estradiol (or any other estrogen) does not prevent heart disease. That your physician did not include progesterone as part of your hormone "replacement" is physiologically unsound. Doctors think that progesterone's only job is to protect the uterus and that with no uterus, all you need is estrogen. That is wrong.

Unopposed estrogen increases the risk of certain diseases and conditions not seen with combination estrogen/progestin (I know that progestin is not progesterone but it is the most studied compound, so I will reference that here, KNOWING that it is a subpar substitute for natural progesterone): increased risk of atrial fibrillaton and a prolonged QT interval (both potentially fatal arrhythmic disturbances); abdominal aortic aneurysm; obviously uterine cancer; possibly ovarian cancer; decreased verbal fluency. Estrogen/progestin also lowers the risk of colorectal cancer and diabetes and improves quality of life (sleep, bodily pain, and emotional wellbeing). (E-alone does not.) Estrogen/progestin is also better for bone than estrogen alone and leads to a greater increase in bone density and sustained fracture prevention even after cessation of therapy. Again, estrogen alone does not.

When a woman complains of heart palpitations and fast heartbeat, that usually occurs during perimenopause, not postmenopause. Perimenopause is not a time of dropping estrogen - rather it is a phase of life characterized by HIGH and swinging estrogen levels and low or absent progesterone. That is why there is a mix of "menopausal" symptoms, like hot flahses and night sweats, but also premenstrual/pubertal symptoms, like sore breasts, heavy flow and mood disturbances.

As far as heart DISEASE is concerned, neither estrogen nor estrogen/progesterone prevents it. Estrogen increases clotting, and it is that pitfall that probably explains why the hormone increases the risk of stroke, blood clots and heart attack. (Remember a woman's own estrogen during pregnancy puts her into a hypercoagulable state, which explains the small increased risk of vascular complications seen in a small percentage of pregnant women.)

August 31, 2014 - 10:19pm


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