Ethics in Medicine

Estrogen Therapy, Now Recommended Again

Kristen Sparrow • April 07, 2011

This is a good column by Gail Collins on the confusing, conflicting medical studies that are reported by the press and how difficult it is to know what to do when it comes to your own health. My own motto might be described as “less is more.” I’ll excerpt a few passages that I think are particularly apt. In this article she is referring to the recent study released this week that showed in women with hysterectomies, the women who received estrogen alone (without progesterone) showed a decreased rate of breast cancer. I think the jury’s out on this one and would need to see more data. Dr. Sidney Wolfe author of “Worst Pills, Best Pills” is quoted in this article. I keep a copy of his excellent book on my shelf as a reference and he recommends that you never take any medication unless it has been out at least 7 years. And that’s what I advise my patients also.
(For more information about my practice click here.)

April 6, 2011
Medicine on the Move

Sometimes you really do want to tell the medical profession to just make up its mind.

We got word this week that estrogen therapy, which was bad, is good again. Possibly. In some cases.
This was not quite as confusing as the news last year that calcium supplements, which used to be very good, are now possibly bad. Although maybe not…
Back in the day, estrogen was prescribed only for women who were experiencing serious problems with menopause. Then a 1966 book called “Feminine Forever” argued that estrogen therapy was good for almost every middle-aged female on the planet who wanted to avoid morphing into a crone. The idea grew in popularity even after evidence mounted that the author had been paid by an estrogen manufacturer...
Now comes a new study — from the very same Women’s Health Initiative — that appears to show that for some women, estrogen alone may actually reduce the risk of breast cancer and heart attack. As long as you take it when you’re in your 50s…
Americans should know by now that you can’t put a pill in your mouth without risk. Television is full of commercials for wonder drugs that will perk up your spirits, soothe your allergies or lower your cholesterol, improving life altogether except in the cases where they lead to vivid dreams, suicidal thoughts, hair loss, stabbing pains or sudden death.
But it still feels as if we need to be on guard against medical overoptimism. “Doctors are far more knowledgeable about the benefits of drugs than the risks,” said Dr. Wolfe. There isn’t always much talk about the possible downside of drugs on which all the evidence is yet to come in, like many fertility treatments.

Dr. Wolfe believes that most doctors prefer writing prescriptions to having lengthy discussions with their patients about things like long-term behavior modification therapy. My own theory is that they just tend to want to satisfy their patients. Let’s face it, few of us go to the doctor with hopes of getting advice on behavior modification. They’re medical practitioners, and their instinct is to solve your problems with medicine…