By Tedler D. Depaynos, MD
It was more than a decade ago when we met. She was a high school teacher then when she suddenly experienced irregular menstruation and months later sudden hot flushes and feeling of warmth. She was diagnosed to have early menopause when her menses eventually stopped because she had more years to come yet before she turned half-century old.
“Menopause” is defined as the cessation of menses while “peri-menopause” is the transition of the reproductive period to non-reproductive one where the individual has to adjust because of the discomfort she starts experiencing. The “post- menopausal” refers to the years that follow. It is during this “peri-menopausal” period when consultations were usually done. It was also this period when she was advised to start taking “estrogen” because her ovaries could no longer produce the hormone. Actually, she was taking her PhD during that time and she researched in the internet before she sought consultations. She knew that it was the lack of “estrogen” that was causing her discomfort and she just wanted to know if it would be alright to take “estrogen” tablets.
During that time it was routine to prescribe “estrogen replacement” therapy except for patients who had a family history of malignancy especially of the breast and the endometrium. Many of them were relieved of their “menopausal symptoms” and many of them even claimed that they were able to maintain their “youthfulness”.
Because of an unfortunate incident where she sorrowfully lost her husband, she retired early from her teaching job and went to Obama country to do “apostolic” work for her children. She continued however to take her medicines. She did not seek any consultations abroad because according to her it was expensive and she did not have any insurance then. Anyway, the medicines were making her feel “good”.
She is presently on vacation and she mentioned that she underwent breast surgery more than a year ago due to a malignant tumor. It was fortunate that it was diagnosed and surgically treated early but she was required to take “anti-estrogen” medications because allegedly, the tumor was “estrogen dependent”. Is it possible that the “estrogen replacement” she had been taking faithfully caused the tumor?
I am not aware of present statistics but prescribing “estrogen” is now with more caution. It is best that it would be done by the OB-Gyn MDs especially those who have cancer sub specialty. They are more aware of present statistics and complications of “estrogen” intake. Besides they are far more experienced in relieving the “menopausal” discomforts of individual patients. She was then advised to visit a specialist she is familiar with.
“Estrogen replacement” in menopausal women may reduce the incidence of certain diseases like coronary heart disease and osteoporosis which may result in weak bones leading to fractures. It may delay the appearance of Alziemer’s Disease and atrophy of the genitourinary organs. Because of possible serious side effects, the giving of this medicine should now be individualized. Perhaps substitute drugs or less harmful ones could be prescribed.
Since it is Christmas time she promised herself to enjoy the season and to visit one or two specialists for their opinions before returning abroad. She then shouted Merry Merry Christmas! Likewise to our readers, Merry Merry Christmas. **
