The Low-Down Dirty Estrogen Blues

Since my uterus left the building in 1995, I haven’t thought about it much.

Except, of course, every time I read about another new study on estrogen therapy, which is about once a month. (I’m convinced that the appropriately-timed frequency is in deference to my phantom menses.)

It happened most recently a few weeks ago, when a new report by the Women’s Health Initiative kicked conventional hormone-replacement theory down the (fallopian) tubes.

The federally-funded study found that taking plain estrogen might actually reduce a woman’s risk of breast cancer and heart attacks—if she takes it in her 50s and has had a hysterectomy.

Ah yes, I remember mine well. Checking into the nurses’ station at 5 a.m., I pounded my fist on the counter and bellowed, “One uterus—to go!” In my world, that was known as acute surgical-anxiety humor. Put another way, I was shysterical.

Uterus-free, I started on estrogen hormone replacement therapy (HRT). Why wouldn’t I? Estrogen used to be prescribed like aspirin. It was supposed to combat the common short-term effects of menopause – no libido, hot flashes, night sweats, no libido, intense mood swings, headaches, no libido, memory loss.

Did I mention no libido? I forget.

Progestin was mixed with the estrogen on the theory that it would reduce the risk of heart disease. But a study by—you guessed it—the Women’s Health Initiative found that not only did it not lower the odds of heart disease, it increased the risk of breast cancer.

Is it me, or does the medical profession appear to suffer mood swings when it comes to menopausal women and their once-raging hormones?

Do I take estrogen, or estrogen plus progestin, or estrogen plus testosterone? Should I worry about heart attacks? Breast cancer? (Uterine cancer is off the table, fortunately.) What do I do when the next study finds that everything I was told was good is bad, and that everything I was told was bad is good?

It’s enough to make a girl turn to drugs. With or without a uterus.