[송무호의 비건뉴스] The inconvenient truth about osteoporosis⑩
Posted on 05.09.2024 at 16:00 Posted on 05.09.2024 at 16:00 Modified on 05.10.2024 at 17:38 Views 615
In order for homeostasis, which keeps our body healthy, to function properly, communication between cells is necessary, and there are two ways to communicate. The first is to communicate quickly and directly through nerves (motor nerves, sensory nerves, sympathetic nerves, parasympathetic nerves) and the other is to communicate slowly and indirectly through hormones (digestive enzymes, blood sugar control, thyroid, adrenal cortex , sexual nerves). hormones, etc.).
Hormones collectively refer to trace amounts of chemicals produced in the body’s endocrine organs. The female hormone estrogen, once praised as “an invention that changed the history of women,” was discovered in its chemical structure in 1930, and Premarin, obtained from estrogen extracted from the urine of pregnant horses, was used as treatment for menopause symptoms in 1942. After receiving FDA approval, it was used on many women.
[사진=클립아트코리아]In 1966, “Feminine Forever,” written by Robert Wilson and sponsored by a pharmaceutical company, became a bestseller, leading to the belief that hormone treatment could prevent menopausal symptoms and enable healthy living after middle age. its use has increased explosively. Subsequently, pharmaceutical companies and the medical community regarded menopause as an “estrogen deficiency disease” and promoted it as “an essential treatment to prevent cardiovascular disease, preserve femininity, and slow aging.” [1].
Controversies over estrogen hormone therapy
Until the early 1970s, doctors considered menopause, like hypothyroidism, to be a hormone deficiency and recommended female hormone treatment to middle-aged women with no health symptoms. Then, in 1975, articles were published in popular journals that estrogen therapy caused endometrial cancer. [2, 3]estrogen use has plummeted.
In the 1980s, when it was learned that combination drugs that added progesterone, which protects the endometrium, to estrogen did not cause endometrial cancer, hormone treatment became popular again. [4].
In 1988, the FDA included not only the treatment of menopausal symptoms but also the prevention of osteoporosis, and when it was even reported to reduce mortality due to cardiovascular disease, hormone therapy became a very common drug used for this purpose. of preventing menopausal symptoms, osteoporosis and cardiovascular disease until the 1990s [5, 6, 7].
However, there are still questions about the effectiveness of hormone treatment in preventing cardiovascular disease, the leading cause of death in Americans. [8], the FDA needed evidence of this. The first study on this topic, HERS (Heart and Estrogen/progestin Replacement Study), was published in 1998, and the results showed that hormone treatment was not effective in preventing cardiovascular disease, adding to the confusion. [9].
Meanwhile, as the Women’s Health Advocate became more active in the 1980s in conjunction with the women’s rights movement in the United States, government organizations were created to research women’s health and public concerns about the safety of female hormone therapy increased and controversy erupted Continuing for 40 years, a large-scale study conducted by the National Institutes of Health (NIH) called the “Women’s Health Initiative study” began in 1997.
The aim of the study was to evaluate the effect and risk of combined estrogen and progesterone therapy on the development of cardiovascular disease and breast cancer in healthy postmenopausal women with a uterus. The first results were published in 2002. [10]. But he was shocking.
Song Moo-ho, MD, orthopedic surgeon
References
1. N Krieger, I Löwy, R Aronowitz, et al. Hormone replacement therapy, cancer, controversies, and women’s health: historical, epidemiological, biological, clinical, and advocacy perspectives. J Epidemiol Community Health 2005;59:740-748.
2. DC Smith, R. Prentice, DJ Thomson et al. Association between exogenous estrogens and endogenous carcinoma. N Engl J Med 1975;293:1164-1167.
3. Hi Ziel, WD Finkle. Increased risk of endometrial cancer among users of conjugated estrogens. N Engl J Med 1975;293:1167-1170.
4. DL Kennedy, C Baum, MB Forbes. Noncontraceptive estrogens and progestins: patterns of use over time. Obstet Gynecol 1985;65:441-446.
5. F Grodstein, MJ Stampfer, GA Colditz, et al. Postmenopausal hormone therapy and mortality. N Engl J Med 1997;336:1769-1775.
6. American Medical Association Guidelines for Counseling Postmenopausal Women About Preventive Hormone Therapy. American College of Physicians. Ann Intern Med 1992;117:1038-1041.
7. DK Wyssowsky, L Golden, L Burke. Menopause estrogen and medroxyprogesterone use in the United States. Obstet Gynecol 1995;85:6-10.
8. RA Lobo, M Whitehead. Too much of a good thing? Progestin use in menopause: an international consensus statement. Fertil Steril 1989;51:229-231.
9. S Hulley, D Grady, T Bush et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. HERS Research Group. JAMA 1998;280:605-613.
10. JE Rossouw, GL Anderson, RL Prentice et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: main findings from the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321-33.
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