Although estrogen does appear to lower cholesterol levels, heart disease prevention is clearly far more complex than cholesterol levels alone. It seems quite clear that estrogen supplementation in postmenopausal women who still have their ovaries does not lower the risk of heart disease.

Of course, if you have been a regular subscriber to this newsletter, you would have already known that by now, as that has been known for the last several years. However, now that the American Heart Association has announced that as its official policy in its journal (Circulation) we can now accept that the traditional medical paradigm has finally officially accepted this fact.

However, it will take many more years before all physicians learn this so don't be surprised if your regular doctor doesn't believe this or does not heed the AHA's advice.

There are other reasons to avoid estrogen, as it also increases the risk of gallbladder disease, venous thromboembolisms, (JAMA 1998 Aug 19;280:605-13) and breast cancer.

However, when a surgeon removes a woman's ovaries, she loses the primary sources of estrogen in her body. I will still routinely prescribe natural estrogens for women who have had their ovaries removed.

The other setting that they appear to be useful for in the short term is women with severe hot flashes that fail to respond to the food choice program or black cohosh. Sleep is vital to good health and if the hot flashes impair sleep, then the minor increase in disease risk is warranted in the short term, as sleep impairment will cause more serious health problems.

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Hormone Replacement Does Not Reduce Heart Disease