The verdict

My doctor called back yesterday evening and spent a long time explaining the HRT study to me. Well, actually, as soon as I told her why I was calling she said, "Am I going off my hormones? Nope."

She said that the study was flawed, which was already fairly apparent. I can't really quote her here because she said a lot of things and I didn't write them all down, but the bottom line is that she feels that the benefits outweigh the risks. She said that the sensational media stories, of course, only concentrated on the bad things. They didn't mention that the risks for several diseases were lowered--colorectal cancer, osteoporosis, and Alzheimer's disease.

She explained the numbers to me, too. I'd already figured them out, but it was nice to have my understanding confirmed. The study said, as I recall, that there was a 26% increase in the risk of breast cancer. But that doesn't mean that my risk increased 26%, it means that if 10 women out of 100,000 would get breast cancer without taking hormones, 13 out of 100,000 might get it. The numbers aren't statistically significant, but they're able to be twisted into sensational news stories.

Another thing she pointed out was that the median age for menopause is around 51 years, I think, but the study involved women up into their late 70's, many of whom were started on hormones for the study, and many of whom, of course, would already have risk factors for cardiac disease.

She said of course if I wanted to go off them, she would support me in that, or if I had any genetic risk factors we might want to reconsider, but as long as I was feeling good, she saw no reason to go off them. She also remarked that if women were dying at 45 like our ancestors did, it would be different, but now that most women live into their 80's, if not beyond, there are definite advantages to hormone therapy.

When I went to see her in the Spring, I mentioned that I had been troubled by my brittle fingernails, and that I was worried that it might mean something was going on, like a thyroid problem. She said I just probably needed to increase my calcium, because, of course, if I was approaching menopause with its attendant bone density problems, a lack of calcium would also make itself known through my nails.

I'd been taking calcium already, but she said I needed to take at least twice what I was taking. I'd been taking 600 MG/day, and she said I should increase it to 1500 MG/day. I started taking two tablets instead of one, and 1200 MG/day have made an incredible, very noticable difference in my nails, so hopefully that means that I'm helping my bones, too.

I asked her when I should have my first bone density test--I would never have thought of it, but my mother had one recently--and she said next year when I come in for my annual exam, we'd schedule one. She said she just had hers and she has "the bones of a teenager!" I said, "Must be all that calcium," and she said, "and all those hormones."