Jen Gunter Instagram – I wrote about the new study looking at the use of hormone therapy for those age 65 and older. This is not starting therapy, but continuing. It is an observational study, so has limitations. Here’s a summary for the estrogen only portion. This does not apply to estrogen plus a progestogen, I will cover that part in another post. My full write up is at TheVajenda.com where you will find a lot more detail. **** In most cases the best outcomes were seen with transdermal or vaginal therapy and at lower or medium doses. One exception is oral Premarin and breast cancer. All the estrogens reduced mortality, with estradiol at 21%, which was better than Premarin at 13%. With breast cancer, had the greatest benefit with a 23% reduction. However, transdermal estradiol was associated with a 14% reduction in breast cancer risk. As expected, low-dose vaginal estrogen, which should not be absorbed, was neutral from a breast cancer reduction perspective. Colon and lung cancer reduction was fairly similar across all the estrogens. The reduction in lung cancer with low-dose vaginal estrogen doesn’t seem biologically plausible! Improvement in heart disease was less certain, but a positive trend was seen with lower doses and transdermal/vaginal. Reduction in dementia was only seen with low dose transdermal. Would not draw any grand conclusions about dementia. There were some issues, specifically some unexplainable health benefits were seen with low dose vaginal estrogen, which sometimes performed better than transdermal estrogen which seems biologically implausible. This suggests there may be some biases we don’t know about and I would causation people from jumping to conclusions about using this study to start therapy, otherwise you are going to have to explain how low dose vaginal estradiol tablets and the estradiol ring reduce lung cancer! Overall, there were no concerning safety signals, and that is reassuring. So the idea that women are increasing their risk of breast cancer, heart disease, or dementia by staying on estrogen therapy over age 65 isn’t supported by this study. Stay tuned for my write up on the estrogen and progestogen part of the study.