I have and, taking into account all the other evidence, would say the statement stands (with emphasis on prolonged: I didn’t define it, but just for the sake of argument, longer than is needed to treat symptoms — would you quibble with that?). Estrogen can be remarkably valuable for many, I agree. In the short term, it may even lower breast cancer risk. But there are long-term risks — on that, I think there is consensus. Someday, I think artificial intelligence models will guide us: Should someone with a BRCA mutation take estrogen? Or someone with a high risk of blood clots? On the other hand, estrogen is often the most effective maneuver for dealing with hot flashes. I think we have to consider the individual and her risks and personal choices regarding risks/benefits. I am by no means saying no one should take estrogen (okay, those with a uterus should not be doing estrogen alone). Appreciate your commentary. Not meant to be a blanket condemnation of HRT in the form of estrogen, but rather a nudge to try, if possible, to avoid very long-term use. Estrogen has many upsides: It helps maintain healthy blood cholesterol levels, helps with vaginal moisture, can reduce the chances of osteoporosis. New data even points to estrogen alone as not increasing breast cancer risk, but I am leery of its use among those with a breast cancer mutation such as BRCA, CHEK, or others. I did edit the piece to say prolonged use of E + P. I am less oncerned about E alone. But each person needs to weigh the risks/benefits. Here's what I have written about estrogen alone (different story with E + progesterone):
